Tumor B7-H1 is associated with poor prognosis in renal cell carcinoma patients with long-term follow-up.
B7-H1 participates in T-cell costimulation functioning as a negative regulator of immunity. Recent observations suggest that B7-H1 is expressed by renal cell carcinoma (RCC) tumor cells and is associated with poor prognosis. However, outcome analyses have been restricted to patients with fresh-frozen tissue and limited follow-up. We report the clinical effect of B7-H1 in RCC patients with a median of 10 years of follow-up. Between 1990 and 1994, 306 patients underwent nephrectomy for clear cell RCC and had paraffin tissue available for review. We did immunohistochemistry with anti-B7-H1 and conducted outcome analyses. Among the 306 patients, 73 (23.9%) harbored tumors with B7-H1 expression. Patients with tumor B7-H1 were at a significantly increased risk of both death from RCC [risk ratio (RR), 3.92; P < 0.001] and overall mortality (RR, 2.37; P < 0.001). The 5-year cancer-specific survival rates were 41.9% and 82.9% for patients with and without tumor B7-H1, respectively. In a multivariate model, tumor B7-H1 remained associated with cancer-specific death even after adjusting for tumor-node-metastasis stage, grade, and performance status (RR, 2.00; P = 0.003). In the subset of 268 patients with localized RCC, tumor B7-H1 was significantly associated with metastatic cancer progression (RR, 3.46; P < 0.001) and death from RCC (RR, 4.13; P < 0.001) even after adjusting for stage, grade, and performance status (RR, 1.78, P = 0.036). RCC patients with tumor B7-H1 are at significant risk of rapid cancer progression and accelerated rates of mortality. B7-H1 may function as a key determinant in RCC, abrogating immune responses directed against this immunogenic tumor.
Department of Urology, Mayo Medical School, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
R Houston
RH
Thompson
Susan M
SM
Kuntz
Bradley C
BC
Leibovich
Haidong
H
Dong
Christine M
CM
Lohse
W Scott
WS
Webster
Shomik
S
Sengupta
Igor
I
Frank
Alexander S
AS
Parker
Horst
H
Zincke
Michael L
ML
Blute
Thomas J
TJ
Sebo
John C
JC
Cheville
Eugene D
ED
Kwon
D015703:Antigens, CD / Q000096:biosynthesis* / Q000276:immunology; D060890:B7-H1 Antigen; D002292:Carcinoma, Renal Cell / Q000276:immunology / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D007680:Kidney Neoplasms / Q000276:immunology / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D009367:Neoplasm Staging; D009392:Nephrectomy; D011379:Prognosis
D015703:Antigens, CD; D060890:B7-H1 Antigen; C423236:CD274 protein, human