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Prognostic value of immunological profile based on CD8+ and FoxP3+ T lymphocytes in the peritumoral and intratumoral subsites for renal cell carcinoma

  • Urology - Original Paper
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Abstract

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.

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Acknowledgements

We would like to thank Prof Demir Kursat Yildiz for his valuable assistance and recommendations in the study.

Funding

The study was funded by the Scientific and Investigational Projects Reserve of the University of Kocaeli (Grant number 2018/138).

Author information

Authors and Affiliations

  1. Department of Urology, Kocaeli University School of Medicine, Umuttepe Campus, 41380, Kocaeli, Turkey

    Kerem Teke, Mustafa Yuksekkaya, Ali Kemal Uslubas, Mehmet Esat Kosem, Hasan Yilmaz, Onder Kara & Ozdal Dillioglugil

  2. Department of Pathology, Kocaeli University School of Medicine, Kocaeli, Turkey

    Busra Yaprak Bayrak

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  1. Kerem Teke
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Contributions

KT: project development, data collection, data analysis, and manuscript writing/editing. BYB: data collection and data analysis. MY: data collection. AKU: data collection. MEK: data collection. HY: data analysis. OK: data analysis and manuscript writing. OD: project development, data analysis, and manuscript writing/editing.

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Correspondence to Kerem Teke.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

Study was approved by ethical committee of Kocaeli University School of Medicine (Approval number KÜ GOKAEK 2018/2.26).

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Teke, K., Yaprak Bayrak, B., Yuksekkaya, M. et al. Prognostic value of immunological profile based on CD8+ and FoxP3+ T lymphocytes in the peritumoral and intratumoral subsites for renal cell carcinoma. Int Urol Nephrol 52, 2289–2299 (2020). https://doi.org/10.1007/s11255-020-02592-x

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