Published in:
01-12-2020 | Kidney Cancer | Urology - Original Paper
Prognostic value of immunological profile based on CD8+ and FoxP3+ T lymphocytes in the peritumoral and intratumoral subsites for renal cell carcinoma
Published in: International Urology and Nephrology | Issue 12/2020
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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 (IPWeak 0–2; and IPStrong 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 IPWeak patients compared to IPStrong (p < 0.05). Kaplan–Meier analysis showed that IPWeak patients had worse OS (62.5 vs. 100%; p = 0.006) and PFS (50 vs. 94.4%; p = 0.002) compared to IPStrong 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.