Relationship Between B7-H1 And Prognosis Of Renal Cell Carcinoma

Objective:This article aims to evaluate the prognostic influence of biological marker of B7-H1 in renal cell carcinoma.Methods:One hundred and thirty two patients with clear cell renal cell carcinoma (from January 2003 to December 2008) had been selected in our department. The paraffin-embedded tumor tissue sections were taken to detect the B7-H1 proten by immunohistochemistry. A Univariate and multiple-factor analysis has been conducted to investigate the relationship of B7-H1 and postoperative prognosis.Results:1. In 132 cases of clear cell carcinoma patients, male 90 cases (68.2%), female 42 cases (31.8%), male: female = 2.14:1, aged 17 years to 82 years, mean age (54.1±12.5) years; immune staining positive in 46 cases (34.85%), negative 86 cases (65.15%). As of the date of last follow-up, 18 cases of death, cancer causing death in 16 cases (12.16%) died, the median survival of 12.8 months (1.6 months to 53.7 months); recurrence in 9 cases (6.82%), health survival of 105 patients (79.55%), median survival follow-up of 29.27 months (9.81 months to 71.97 months). B7-H1 expression in 86 patients with negative patients, the health of 79 patients, 3 cases of recurrence, 4 died. Disease progression-free survival(PFS) rate was 91.9%, overall survival(OS) was 95.4%; 46 cases of the expression of B7-H1 positive patients, the health survival in 26 cases, 6 cases of recurrence, 14 patients died. PFS rate was 56.5%, OS rate was 69.5%.2. In the 46 positive cases, male 16 cases , female 30 cases. 27 patients over 60 years and 19 patients Less than 60 yars. 33 patients have the tumor diameter Not less than 5cm and 13 patients less than 5cm.The primary tumor stage T1 ~ T4 have 19 cases, 8 cases, 18 cases and 1 case, respectively.Regional lymph nodes or metastasis can not be assessed in 33 patients and13 patients with lymph node metastasis. 32 patients have no distant metastasis and distant metastases in 14 cases. The clinical stageⅠ~Ⅳhavef 17 cases, 9 cases, 17 cases and 3 cases, respectively.In the 86 B7-H1express negtive cases, male26 cases , female60 cases. 61 patients over 60 years and 25 patients Less than 60 yars. 47 patients have the tumor diameter Not less than 5cm and 39 patients less than 5cm.The primary tumor stage T1 ~ T4 have 64 cases, 15 cases, 6 cases and 1 case, respectively.Regional lymph nodes or metastasis can not be assessed in84 patients and 2 patients with lymph node metastasis. 78 patients have no distant metastasis and distant metastases in 8 cases. The clinical stageⅠ~Ⅳhavef 63 cases, 15 cases, 6 cases and 2 cases, respectively.3. B7-H1 positive patients 1, 3, 5-year cancer-specific survival rates were 84.78%, 78.26%, 69.57%, while the B7-H1-negative patients with tumor-specific 1,3,5-year survival rates were 100 %, 98.81%, 97.62%, the difference was significant (P <0.05)..4. Univariate analysis showed a significant association between B7-H1-positive tumor and primary tumor size, primary tumor classification, regional lymph node, distant metastases and Clinical Stage (each p <0.001). No relationship was observed between B7-H1-positive tumor and patients'age and gender.5. Multivariate analysis showed that B7-H1express positive was an independent predictor of cancer-specific death rate [RR,3.918,95%CI,1.305～11.765,P<0.05]and relapse rate[RR,4.486,95%CI, 1.404~14.333,P<0.05] after for the control of primary tumor size, primary tumor classification, regional lymph node, distant metastases, Clinical Stage and immunotherapy.Conclusions:1. This research concluded that patients with renal clear cell carcinoma B7-H1+ has positive correlation with cancer-specific death rate and relapse rate . And B7-H1 is an independent prognostic factor in renal clear cell carcinoma.2. Detection of B7-H1 is expected to select which of high-risk groups to use different methods and follow-up of early diagnosis and treatment of the basis...