Wong Chung-Shun, Chen Tzu-Ting, Chang Wei-Pin, Wong Henry Sung-Ching, Wu Mei-Yi, Adikusuma Wirawan, Lin Yuh-Feng, Chang Wei-Chiao
Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei City 110, Taiwan.
Department of Emergency Medicine, Taipei Medical University-Shuang Ho Hospital, New Taipei City 23561, Taiwan.
Cancers (Basel). 2020 Jun 22;12(6):1654. doi: 10.3390/cancers12061654.
The effect of comorbidities and the immune profiles of the kidney cancer microenvironment play a major role in patients' prognosis and survival. Using the National Health Insurance Research Database (Taiwan), we identified patients aged >20 years with a first diagnosis of kidney cancer between 2005 and 2014. Differences in demographic characteristics and comorbidities were examined using the Pearson chi-squared test or the t test. The Cox regression model was used to construct the nomogram. RNA-seq data were applied from The Cancer Genome Atlas database, and correlations between immune metagenes and clinical characteristics were determined using a linear regression model. In this nationwide cohort study, including 5090 patients with kidney cancer, predictors in our prediction models included age, sex, chronic kidney disease, dialysis requirements, renal stones, cerebrovascular disease, and metastasis tumor. In the tumor tissue profiles, significant positive correlations between immune metagenes and clinical stage or overall survival were observed among Natural Killer (NK) cells (CD56-), CD4+ T-helper 2 (Th2) cells, and activated Dendritic Cell (aDC). A negative correlation was observed between expression level of Dendritic Cell (DC) and overall survival. Patients with kidney cancer exhibit high prevalence of comorbid disease, especially in older patients. Comorbid disease types exert unique effects, and a particular comorbidity can affect cancer mortality. Moreover, the expression of immune metagenes can be utilized as potentialbiomarkers especially for further study of molecular mechanisms as well as microenvironments in kidney cancer.
合并症及肾癌微环境的免疫特征对患者的预后和生存起着主要作用。利用台湾地区国民健康保险研究数据库，我们确定了2005年至2014年间首次诊断为肾癌的20岁以上患者。使用Pearson卡方检验或t检验来检查人口统计学特征和合并症的差异。采用Cox回归模型构建列线图。应用来自癌症基因组图谱数据库的RNA测序数据，并使用线性回归模型确定免疫元基因与临床特征之间的相关性。在这项纳入5090例肾癌患者的全国性队列研究中，我们预测模型中的预测因素包括年龄、性别、慢性肾病、透析需求、肾结石、脑血管疾病和转移瘤。在肿瘤组织谱中，自然杀伤（NK）细胞（CD56-）、CD4 +辅助性T细胞2（Th2）和活化树突状细胞（aDC）的免疫元基因与临床分期或总生存期之间存在显著正相关。树突状细胞（DC）的表达水平与总生存期呈负相关。肾癌患者合并症的患病率较高，尤其是老年患者。合并症类型具有独特的影响，特定的合并症会影响癌症死亡率。此外，免疫元基因的表达可作为潜在的生物标志物，特别是用于进一步研究肾癌的分子机制和微环境。
