Retrospective Analysis Of SCLC And The Study Of The Immunotherapy-related Targets In SCLC

Background and Objective Though small cell lung cancer(SCLC) accounts 13-15% in lung cancer, but it is the most malignant in the lung cancer. The therapy of SCLL has not improved many years. Recent years, the appearance of immune blocking agents like PD-L1/PD1 and new immunotherapy like CAR-T has bring hope to the cancer patients including small cell lung cancer(SCLC) and non-small cell lung cancer(NSCLC). In my research, we gathered the SCLL sample in our department in recent 5 years and detected the expression of PD-L1, PD1 and mesothelin in these specimen and discuss the feasibility of immunotherapy about PD-L1/PD1 in SCLC.Materials and methods We have collected 96 patients’ specimen from our department which had identified small cell lung cancer by our pathology department. After we organized the basic information of the 96 patients, there are 77 patients’ data are integrated. The patients’ information collected from our huge department database and our hospital’s medical records room. Then make this information write in EXCEL and at the same time construct the database in SPSS. The follow-up visit methods are telephone and outpatient. The patient’s conservation status and death time identified through Telephone and outpatient follow-up. 28 patients selected from patients above using immunohistochemical method for PD- between L1, PD1 and Mesothelin, analyse of the patients clinical data and the influence of the expression of three proteins for survival mainly with Kaplan Meier curve. each index between the clinical characteristics with the use of Fisher’s exact test method, inspection, use statistical software for SPSS21.0, P value point 0.05, less than 0.05 is that has a statistical significance.Results: 1. Patients with small cell lung cancer, male patients and the history of smoking be in the majority, but include gender, age, tumor location, or smoking history of the patients have no obvious influence of the long-term prognosis. 2. With the study with the incidence rate of metastasis sites, The results indicates that the highest incidence sites wound be brain metastasis, adrenal metastasis is the most rare. 3. Further analysis found that in 68 cases of patients who were not preventive brain irradiation, 18 patients got brain metastases, its incidence is 26.47%, and within 6 patients with routine preventive brain irradiation, only 1 case got brain metastasis, the incidence was 16.67%.This result suggest may PCI prevent brain metastases, but the two groups was no significant statistical difference(P > 0.05). 4, For extended small cell lung cancer patients, patients with treatment(surgery plus chemotherapy, chemotherapy plus surgery and chemotherapy and chemotherapy alone) got a median surial of 12 months(5-72 months), the group not treated got the median surial within 3 months. But different treatments, among the survival show no significant difference. 5. The expression rate of PD1 and PD-L1 in small cell lung cancer both is 50%(14/28), and the expression rate of mesothelium is 42.8%(12/28). The correlation between the expression of PD-L1, PD1 and mesothelin shows irrelevant.The expression of PD1 shows opposite correlation with the outcome of the patients. 6. In the primary tumors and metastases, the expression of PD1,PD-L1 and mesothelin showed no relevance.Conclusion: 1. Patients with small cell lung cancer, male patients and the history of smoking be in the majority, but include gender, age, tumor location, or smoking history of the patients have no obvious influence of the long-term prognosis. 2. In patients with the final metastases, brain metastasis is one of the most common sites of metastasis. 3. Prophylactic cranial irradiation can play a role in inhibiting the action of the brain metastases. 4. For patients with extended small cell lung cancer, without accepting treatment the survival timen might within 3 months, different treatment including surgery, directly compared neoadjuvant chemotherapy and chemotherapy only, the survival showed no significant difference. 5. The expression PD-L1, PD1 and mesothelium may be regulated in genetic levels,and showed no obvious correlation.The expression of PD1 significantly reduced the prognosis of patients. 6. In addition we found in primary tumors and metastases, the expression of PD- L1, PD1 and mesothelium can be the same or different.