目的探讨小细胞肺癌(yn)、嗜 铬蛋白(CgA)表达水平检测的临床意义。 方法 收集2015年3月-2017年3月在我院经 病理证实的45例SCLC患者及50例非小细 胞肺癌(NSCLC)患者，术前均行CT检查， 并采用免疫组化法检测癌组织及癌旁组 织中神经内分泌标志物Syn、CgA表达情 况。结果 SCLC胸腔积液、纵膈淋巴结 融合等CT征象出现比例分别为44.44%、 71.11%，明显高于NSCLC组的20.00%、 16.00%(P<0.05)，而两组在心包积液、 胸膜转移、远处转移、大血管受侵等其 他CT征象出现比例上差异无统计学意义 (P>0.05)。Syn、CgA在SCLC中阳性表达 率为86.67%、53.33%，明显高于它们在 NSCLC中阳性表达率(16.00%、4.00%)，差 异均有统计学意义(P<0.05)。在肺癌诊断 中，CT联合Syn、CgA检查鉴别SCLC的敏 感度、特异度、准确度分别为93.33%、 94.00%、93.68%，均明显优于单一检查， 差异有统计学意义(P<0.05)。结论 Syn、 CgA在SCLC与NSCLC中表达有明显差异，联 合CT扫描有助于提高SCLC的鉴别诊断水 平。

Objective To investigate the clinical significance of CT scan and the detection of expression levels of synaptophysin (Syn) and chromogranin (CgA) in cancer tissues of patients with small cell lung cancer (SCLC). Methods Forty-five patients with SCLC and fifty patients with non-small cell lung cancer (NSCLC) pathologically confirmed in the hospital from March 2015 to March 2017 were selected. All patients underwent CT examination before operation. The expression of neuroendocrine markers Syn and CgA in cancer tissues and adjacent tissues was detected by immunohistochemistry. Results The incidence rates of CT signs pleural effusion and mediastinal lymph node fusion in SCLC group (44.44% and 71.11%) were significantly higher than those in NSCLC group (20.00% and 16.00%) (P<0.05). However, there was no significant difference between the two groups in the other CT signs such as pericardial effusion, pleural metastasis, distant metastasis and macrovascular invasion (P>0.05). The positive expression rates of Syn and CgA in SCLC group (86.67% and 53.33%) were significantly higher than those in NSCLC group (16.00% and 4.00%) (P<0.05). The sensitivity, specificity and accuracy of CT combined with Syn and CgA in the diagnosis of SCLC (93.33%, 94.00% and 93.68%) were significantly better than those of single test (P<0.05). Conclusion The expression of Syn and CgA in SCLC and NSCLC are significantly different. Combined use of CT scan can help to improve the differential diagnosis of SCLC.