• Wei Wang, Philip Hodkinson, Fiona McLaren, Melanie J Mackean, Linda Williams, Howie Sarah E M SEM MRC Centre for Inflammation Research, University of Edinburgh, Edinburgh, Scotland., Wallace William A H WAH MRC Centre for Inflammation Research, University of Edinburgh, Edinburgh, Scotland; Department of Pathology, Royal Infirmary of Edinburgh, Edinbur, and Tariq Sethi.
• Department of Respiratory Medicine and Allergy, King's College London, London, England; MRC Centre for Inflammation Research, University of Edinburgh, Edinburgh, Scotland.
• Chest. 2013 Jan 1; 143 (1): 146-151.

BackgroundSmall 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.MethodsSixty-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.ResultsThe 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).ConclusionsThe 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.

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