The Relation Of Immune Cytokines In Peripheral Blood To Curative Effect And Prognosis On SCLC

【Objective】To identify the systemic immune status of cancer patients with testingexpression of tumor related cytokines IL-2, IL-6，TGF-β1，HIF-1，PD-1，PD-L1，CTLA-4in peripheral blood microenvironment of SCLC before treatment andtreatment of1-7cycle dynamic.we analyzeThe dynamic expression of the cytokinesand observe the Small cell lung cancer patients with the change trend of developmentcourse of cytokine, understand the relationship between the dynamic change and effectfactor concentration, try to discover the immune factors associated with treatmentefficacy in7tumor related cytokines, and prediction of tumor recurrence indicators canbe found to effectively predict the therapeutic index of Xiao, for the development ofanti relapse treatment, more effective programs to provide theoretical support. Inaddition, we have to follow the above into the group of patients, screening indexesrelated to prognosis of high-risk groups, specific need to actively adopt rationalmethods of intervention therapy. This study also linked the immune status of patientswith treatment, combination of immunotherapy and chemotherapy to find the bestentry point, and provides the basis for treatment decisions.【Method】the first part: a collection of43cases of ED/LD in peripheral blood ofSCLC patients, the detection of IL-2, the group in the peripheral blood of patients withIL-6by ELISA method, TGF-β1, HIF-1α, PD-1, PD-L1, CTLA-4,7cell immunefactors before treatment, the expression levels and in the course of treatment,7AStudy on evaluation factor in different period, different treatment groups, theconcentration difference in different time points. The second part: the differencebetween the dynamic change trend in different treatment groups on each factor,dynamic change point in time for the1-7cycles of chemotherapy, to explore therelationship between effect of cytokines in peripheral blood of dynamic related tumor environment change and small cell lung cancer, immune factors and find time topredict the effect of. The third part: to follow up the above into the group of patients,screening index, prognosis of IL-2, IL-6, TGF-β1, HIF-1α, PD-1, PD-L1, CTLA-4inthe1-7cycles of chemotherapy in each cycle of the expression and prognosis ofpatients with SCLC.【Results】this study was designed to explore the relationship between the expressionof immune factors and the short-term curative effect. We discussed7cytokines inrespectively in2,4,6cycles of chemotherapy evaluation, PR, PD, SD cytokinesexpression between the three groups of concentration difference. The results showedthat2W cells; evaluation of HIF1α, TGF β, PDL1, CTLA-4showed SD> PR> PDconcentration difference, statistical difference.4W,6W evaluation is not statisticallydifferent.In the different treatment groups, immune factors with the changing trends ofthe progression of, results showed: the cytokines PD-1, CTLA-4in4W evaluation,change trend, meaningful evaluation of6W before2wPRSD,6wSD (always effective)group of inhibitor concentration continues to decrease, while the2wPRSD,6wPD(early on) group concentrations continue to rise. The difference was statisticallysignificant trends, PD-1(P=0.006), CTLA-4(P=0.009) of two groups were significantconcentration change trend. By using the method of the same, cytokines HIF, PD-L1can predict the efficacy, at an earlier point in time the results showed that: HIF, PD-L1can predict the efficacy, at an earlier time point (2wPR,6wSD always effective) groupin the2cycle assessment after concentration rose gradually, gradually decreased, in thefourth cycle assessment and2wPR,6wPD (early progression) group, but in the2cycleafter the evaluation expression concentration did not rise, but further decline, the rapidrise in the4cycle after evaluation.. HIF (P=0.017), PD-L1(P=0.009) two changessignificant statistical difference.SCLC peripheral blood immune micro environmentrelated cytokines and survival in patients with SCLC, at the beginning, HIF, CTLA-4concentration was higher than the normal people, PD-1lower than normal people, nostatistically significant differences in concentration of IL-2, TGF β; the higher thannormal trend, IL-6, PD-L1below the normal trend, but no significant difference. IL-6, TGF β expression in this study in smokers. HIF-1α, PD-1, CTLA-4was negativelycorrelated with PFS, IL-2was positively correlated with PFS, are independentprognostic factors for small cell lung cancer PFS cells. The PD-1and CTLA-4, PD-1and HIF and PFS joint inspection, the results showed that PD-1and CTLA-4werelower expression in the PFS analysis showed a significant survival advantage; PD-1and HIF are highly expressed in PFS analysis showed a significant survival advantage;7factor between two two highly positive correlation.【Conclusion】the abnormal expression of cell factor in the peripheral blood of SCLCpatients, TGF-β1, HIF-1α, CTLA-4and other immunosuppressive factor in highexpression in the peripheral blood of SCLC patients, showed that NSCLC patients withsystemic immune complex in the state of immune suppression. The concentrationdifference in expression of α, TGF β, PDL1, CTLA-4four inhibits cytokine HIF1associated with early treatment,2W evaluation showed SD> PR> PD concentrationdifference, effect of SD group was much higher than the normal value, the efficacy ofPD group was close to or lower than the normal value, and the effect of PR, betweenconcentration between the two.Study of PD-1in different treatment groups each factordynamic change trend, HIF, PD-L1, CTLA-4, with pre side value for the6W effect.The concentration factor expression in imaging diagnosis for progress, may appearconcentration gradually increased. In particular, HIF, PD-L1may be earlier than theimaging diagnosis of1-4months, may be more predictive value for response.Theperipheral blood of patients with SCLC immune micro environment is in a state ofimmune suppression. HIF-1α, PD-1, CTLA-4and IL-2in the peripheral bloodexpression level is strongly related factors of prognosis of SCLC. HIF-1α, PD-1,CTLA-4was negatively correlated with PFS, IL-2was positively correlated with PFS,are independent prognostic factors for small celllungcancerPFScells.PD-1andCTLA-4,combined with PD-1and HIF expression is an independent prognostic marker inED/LD stage SCLC. Through the detection of small cell lung cancer in peripheralblood IL-2, IL-6, TGF-β1, HIF-1α, PD-1, PD-L1, the expression level of CTLA-4inperipheral blood, immune status assessment, is expected to be able to identify patients at high risk, so that these patients benefit from appropriate treatment decisions.