title: Histologic assessment of tumor-associated CD45(+) cell numbers is an independent predictor of prognosis in small cell lung cancer.
abstract: BACKGROUND
  Small cell lung carcinoma (SCLC) continues to have a poor prognosis, with a 2-year survival of < 20%. Studies have suggested that SCLC may affect the immune system to allow it to evade immunologic responses. We hypothesized that any such effect would be characterized by a decrease in the lymphoid cells associated with the tumor in biopsy specimens and that this might relate to patient outcome.
  
  
  METHODS
  Sixty-four SCLC biopsy specimens were immunohistochemically stained with anti-CD45 antibody to identify immune cells associated with the tumor. A mean CD45 count per high-power field for each case was obtained, and the results were correlated with age, sex, stage, performance status (PS), treatment with chemotherapy/radiotherapy, and overall survival.
  
  
  RESULTS
  The median CD45 count for all cases was taken as 40 (CD45(40)). Kaplan-Meier plots demonstrated better survival for patients with a CD45(40) > 40 ( P < .009). No relationship between CD45 40 and age, sex, stage, or treatment by chemotherapy or radiotherapy was identified. Although PS was a significant predictor of survival ( P = .014), it did not correlate with CD45 40. In patients with better Eastern Cooperative Oncology Group PS (≤ 2), the CD45(40) demonstrated a highly significant survival advantage for those with CD45(40) > 40 ( P < .0001).
  
  
  CONCLUSIONS
  The data indicate that (1) simple immunohistochemical assessment of immune cell infiltrates in routinely processed and stained biopsy specimens of primary tumors can provide prognostic information in SCLC and (2) tumor-associated CD45(+) cells in SCLC biopsy specimens may be a good clinical marker to identify patients with poor prognosis despite good PS.
authors: Department of Respiratory Medicine and Allergy, King's College London, London, England; MRC Centre for Inflammation Research, University of Edinburgh, Edinburgh, Scotland.
authors: Wei
authors: W
authors: Wang
authors: Department of Respiratory Medicine, Crosshouse Hospital, Kilmarnock; MRC Centre for Inflammation Research, University of Edinburgh, Edinburgh, Scotland.
authors: Philip
authors: P
authors: Hodkinson
authors: MRC Centre for Inflammation Research, University of Edinburgh, Edinburgh, Scotland.
authors: Fiona
authors: F
authors: McLaren
authors: Department of Medical Oncology, Edinburgh Cancer Centre, Edinburgh, Scotland.
authors: Melanie J
authors: MJ
authors: Mackean
authors: Centre for Population Health Sciences, University of Edinburgh, Edinburgh, Scotland.
authors: Linda
authors: L
authors: Williams
authors: MRC Centre for Inflammation Research, University of Edinburgh, Edinburgh, Scotland.
authors: Sarah E M
authors: SEM
authors: Howie
authors: MRC Centre for Inflammation Research, University of Edinburgh, Edinburgh, Scotland; Department of Pathology, Royal Infirmary of Edinburgh, Edinburgh, Scotland.
authors: William A H
authors: WAH
authors: Wallace
authors: Department of Respiratory Medicine and Allergy, King's College London, London, England; MRC Centre for Inflammation Research, University of Edinburgh, Edinburgh, Scotland. Electronic address: tariq.sethi@kcl.ac.uk.
authors: Tariq
authors: T
authors: Sethi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000378:metabolism; D002452:Cell Count; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D017493:Leukocyte Common Antigens / Q000378:metabolism*; D007962:Leukocytes / Q000276:immunology* / Q000378:metabolism; D008175:Lung Neoplasms / Q000175:diagnosis / Q000276:immunology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D055752:Small Cell Lung Carcinoma / Q000175:diagnosis / Q000276:immunology / Q000473:pathology
chemical_list: D015415:Biomarkers; D017493:Leukocyte Common Antigens; C516769:PTPRC protein, human