Study On Expression Of PAX-5,TdT,CD19 And CD34 In Small Cell Lung Cancer

Objective: Small cell lung cancer is a highly malignant neuroendocrine tumor that is prone to metastasis,has a poor prognosis,and has a small round shape.PAX-5 is a B-lymphocytespecific immunolabeling molecule expressed in B lymphoblastic lymphoma and some B-cell lymphoma.In recent years,a few studies have reported that PAX-5 can be expressed in small cell lung cancer,which makes it difficult to differentiate small cell lung cancer from B-cell lymphoma,especially B-lymphoblastic lymphoma.In addition,TdT,CD34 and CD19 are positive in B lymphoblastic lymphoma and their expression in small cell lung cancer is rarely studied.Therefore,the purpose of this study is to study the expression of PAX-5,TdT,CD34 and CD19 in small cell lung cancer,further confirm the expression of PAX-5 in small cell lung cancer,provide theoretical basis for differential diagnosis of small cell lung cancer and B-cell lymphoma,avoid misdiagnosis of small cell lung cancer as B lymphoblastic lymphoma and explore the relationship between PAX-5 and clinicopathological characteristics of small cell lung cancer patients and the impact on survival of patients.Methods: From January 2016 to June 2017,41 cases of biopsy specimens of small cell lung cancer diagnosed in the Department of Pathology of Shaanxi Provincial People’s Hospital(3 cases of surgical specimens,38 cases of bronchoscopy biopsy specimens)were collected.At the same time,19 cases of bronchoscopy biopsy specimens with pathological diagnosis of bronchial chronic inflammation were collected as controls.All cases were followed up,pathological sections were re-read,clinical pathological data were collected,and immunohistochemical SP method was used to immunohistochemical staining of PAX-5,TdT,CD34 and CD19.To study the expression of the above four indicators in small cell lung cancer and its relation with clinicopathological features,and to explore the impact on prognosis.Results:1.PAX-5 is expressed in small cell lung cancer.the positive rate is 39%,moderately positive in 4 cases,and weakly positive in 12 cases,but not expressed in mucosal chronic inflammation tissues(0/19).Statistical analysis showed that the expression of PAX-5 in small cell lung cancer and bronchial chronic inflammation tissues was statistically significant(p<0.01).2.The expression of PAX-5 in small cell lung cancer was not correlated with age,gender,history of smoking,clinical stage(limited period and extensive period),and lymph node metastasis(P>0.05).3.The expression of PAX-5 in small cell lung cancer was not correlated with the expression of CgA,TTF-1,Syn and CD56 in small cell lung cancer(P>0.05).4.TdT,CD19 and CD34 were not expressed in small cell lung cancer.5.41 patients with small cell lung cancer were followed up by telephone and patient review.22 patients were followed up and 19 were lost to follow-up.We followed up to 3 of the 22 patients and 19 died,with a survival rate of 13.6%.The median survival time of PAX-5 positive patients was 9 months,and the median survival time of PAX-5 negative patients was 8 months.The difference was not statistically significant(P>0.05).The median survival time of patients with limited period was 24 months,and the median survival time of patients with extensive disease was 4 months.The difference was statistically significant(P=0.009,P<0.05).Conclusions:1.PAX-5 was expressed in small cell lung cancer(39%),but TdT,CD19 and CD34 were not expressed in small cell lung cancer.Recognizing this is of great significance in differential diagnosis between small cell lung cancer and B lymphoblastic lymphoma.We can avoid misdiagnosis of small cell lung cancer as B lymphoblastic lymphoma.2.The expression of PAX-5 in small cell lung cancer has no correlation with age,gender,history of smoking,clinical stage(limited period and extensive period),and whether there is lymph node metastasis.3.The expression of PAX-5 in small cell lung cancer has no correlation with expression of CgA,TTF-1,Syn and CD56.4.PAX-5 is not associated with prognosis,and clinical stage(limited and extensive)may be a prognostic factor.