Research Information System
INTERNATIONAL UROLOGY AND NEPHROLOGY, no.12, pp.2289-2299, 2020 (SCI-Expanded)
Purpose We aimed to assess an "Immunological Profile (IP)" including CD8+ and FoxP3+ T lymphocytes for renal cell carcinoma (RCC) to evaluate its effects on tumor pathological characteristics, disease progression, and survival. Methods Adjacent normal and intratumoral specimens from 42 patients who had undergone radical nephrectomy for RCC were analyzed for counts of CD8+ and FoxP3+ T lymphocytes by immunohistochemistry. Tissue from both sites were evaluated and scored separately according to low (0) or high (1) expression of CD8 and FoxP3. A total score (min: 0, max: 4) was assigned to each patient. Thereafter, patients were divided into two groups for clinicopathologic and survival stratification based on score (IP(Weak)0-2; and IP(Strong)3-4). Survival curves were constructed using the Kaplan-Meier method, and a multivariable Cox regression model was used for overall survival (OS) and progression-free survival (PFS). Results The mean follow-up was 54.73 +/- 21.34 months. Poor RCC characteristics including pT3-T4, tumor necrosis, lymphovascular invasion, lymph node involvement, and larger tumor size were significantly more common in the IP(Weak)patients compared to IPStrong(p < 0.05). Kaplan-Meier analysis showed that IP(Weak)patients had worse OS (62.5 vs. 100%;p = 0.006) and PFS (50 vs. 94.4%;p = 0.002) compared to IP(Strong)patients. In multivariable analysis, IPWeak(HR 8.64; 95% CI 1.09-68.05,p = 0.042) and high tumor node metastasis stage (HR 45.33; 95% CI 4.69-437.68,p < 0.001) were significant independent predictors of poor PFS. Conclusion Assessment of IP including CD8+ and FoxP3+ T lymphocytes in adjacent normal and intratumoral sites in RCC may serve as a good predictive marker for PFS.