Relationship Among The Frequency Of Regulatory T Cells In Peripheral Blood And In Tumor Tissue, Prognosis, And Sensitivity Of Postoperative Immunotherapy In Renal Cell Carcinoma Patients

Objective: To detect the frequency of Treg in peripheral blood and tumor tissue of patients with renal cell carcinoma. To evaluate the relationship between frequency of Treg and prognosis of patients with renal cell carcinoma and the clinical effect of postoperative immunotherapy by testing the frequency of Treg in peripheral blood and tumor tissue of patients.Contents: Overall, 30 patients were eligible for the study, including 14 male and 16 female, aged from 16 to 70 years old, median age being 54 years old. All of the patients accepted radical surgery already, which any distant metastases were not found during operation. The tissue of tumor for experiment directly sampled from the operative specimen. The frequency of Treg in peripheral blood and tumor tissue had been analyzed by flow cytometry. The clinical effect of postoperative immunotherapy of interleukin-2 (IL-2), interferon-α(INF-α) combine with 5-fluorouracil (5-FU) was evaluated by postoperative follow-up visit for three years. The relation between frequency of Treg in peripheral blood and tumor tissue and that of response to immunotherapy between them was analyzed.Methods: From August 2006 to August 2007, 30 patients were eligible for the study, including 14 male and 16 female, aged from 16 to 70 years old, median age being 54 years old. All of the patients accepted radical surgery, and were not found any distant metastases during operation. The frequency of CD4~+, CD25~+, Foxp3~+, and Treg had been analyzed in peripheral blood mononuclear cells and tissue of tumor by flow cytometry and immunohistochemistry. SPSS 13.0 was used to analyze correlation between the frequency of CD4~+CD25~+Foxp3~+ Treg and prognosis of postoperative patients. All patients received 1-3 course of immunotherapy that include interleukin-2 (IL-2), interferon-α(INF-α) and 5-fluorouracil (5-FU) in postoperative 1-2 weeks. The relation between frequency of Treg in peripheral blood and tumor tissue and that of the response to immunotherapy were analyzed.Results: There was significant relationship between the frequency of CD4~+ , CD25~+ , Foxp3~+ and Treg in peripheral blood and tumor tissue of patients with renal cell carcinoma with the prognosis of patients. The follow-up data showed an association between higher peripheral blood regulatory T cell count and adverse overall survival. The patients with higher frequency of CD4~+, CD25~+, Foxp3~+ had better response to immunotherapy (interleukin-2, interferon-αand 5-fluorouracil).Conclusion: Up-regulation of frequency of CD4~+, CD25~+, Foxp3~+, and Treg could inhibit the anti-tumor immunological effect of the body, and thus promote renal cell carcinoma metastasis and recurrence. The practical value of the increasing of frequency of Treg is to predict poor prognosis and make the decision of postoperative treatment protocol.