Expression And Clinical Significance Of LAG-3、NLR、PLR In Small Cell Lung Cancer

Objective:To investigate the expression of lymphocyte activation gene-3(LAG-3),platelet lymphocyte ratio(PLR),and neutrophil lymphocyte ratio(NLR)in small cell lung cancer and its clinical significance.Methods:57 cases of limited SCLC lung tissues paraffin specimen without any treatment and 16 cases of normal lung tissues were collected in Hebei General Hospital Pathology department from June 2012 to June 2016.Detect the expression of LAG-3 in cancer tissues and normal tissues by the method of Immunohistochemical SP.The blood routine of 30 health examiners was collected,and compare the levels of NLR and PLR between the SCLC patients before treatment and the health examiners.Then evaluate the relationship between LAG-3,NLR,PLR and the therapeutic effect and prognosis.Results:1 Relationships between the LAG-3,NLR and PLR with the clinicopathologic features in SCLCThe expression of LAG-3 protein in SCLC tissues was positively related to age,tumor size and lymph node metastasis.The levels of NLR and PLR in peripheral blood were higher than healthy control group.NLR was positively correlated with the ECOG score and lymph node metastasis,and PLR was only positively correlated with lymph node metastasis.2 The relationship between LAG-3,NLR,PLR and the therapeutic effectThere was no correlation between the expression of LAG-3 protein,the levels of NLR and PLR in the effective rate of SCLC chemotherapy.Poor curative effect in patients with high level NLR and PLR.And there was no correlation expression of LAG-3 between the effect of radiotherapy.3 The relationship between LAG-3,NLR,PLR and prognosisThe median OS in LAG-3 positive group and negative group were respectively 19 months and 29.5 months.Those survival rates of 1,2 and 3year were respectively 73.9%、34.8%、2.9%and 91.2%、58.8%、32.4%,there was a statistically significant(χ~2=7.729,P=0.005).The median OS in high NLR and low NLR were respectively 21 months and 29 months.Those survival rates of 1,2 and 3 year were respectively 78.6%、38.3%、14.3%and90%、58.6%、41.4%,there was a statistically significant(χ~2=4.238,P=0.040).The median OS in high PLR and low PLR were respectively 19 months and30 months.Those survival rates of 1,2 and 3 year survival rates were respectively 83.3%、25%、4.2%and 84.8%、66.7%、45.5%,there was a statistically significant(χ~2=8.582,P=0.003).Univariate analysis showed that tumor size,lymph node metastasis,LAG-3 expression,and PLR levels in peripheral blood were related to OS.Cox multivariate analysis showed that tumor size,lymph node metastasis,and PLR levels were independent prognostic factors of OS(P<0.05).Conclusions:1 The expression ratio of LAG-3 protein in SCLC tissues was higher than normal lung tissue,and the level of NLR and PLR in peripheral blood of SCLC patients was higher than normal people.2 The prognosis of SCLC patients with positive expression of LAG-3protein,high level NLR and PLR was poor.The high level of NLR and PLR were negatively correlated with the radiotherapy effect.3 The prognosis of SCLC was related to immune microenvironment and inflammatory microenvironment.