Özalp Faruk Recep, Yörükoğlu Kutsal, Çalışkan Yıldırım Eda, Uzun Mehmet, Demirciler Erkut, Semiz Hüseyin Salih
Department of Medical Oncology, Faculty of Medicine, Dokuz Eylul University, 35340 Izmir, Turkey.
Department of Pathology, Faculty of Medicine, Dokuz Eylul University, 35340 Izmir, Turkey.
Medicina (Kaunas). 2025 May 9;61(5):867. doi: 10.3390/medicina61050867.
: Renal cell carcinoma (RCC) is a biologically heterogeneous malignancy, and traditional prognostic models often fail to provide accurate risk stratification. B7-H3 (CD276), an immune checkpoint molecule, has been implicated in RCC progression but remains underexplored as a prognostic biomarker. : This retrospective study analyzed 52 patients with localized RCC who underwent nephrectomy. Immunohistochemical staining was used to assess B7-H3 expression. A novel prognostic scoring system, the Renal Immune Prognostic Index (RIPI), incorporating B7-H3 expression, tumor necrosis, tumor grade, and pathological staging, was developed and validated. Kaplan-Meier survival analysis and Cox proportional hazard models were employed to evaluate disease-free survival (DFS) and overall survival (OS). : High B7-H3 expression was significantly associated with shorter DFS (12 vs. 54 months; = 0.001) and OS (70 vs. 123 months; = 0.002). The RIPI demonstrated strong prognostic performance, stratifying the patients into distinct risk groups with a C-index of 0.82. The high-risk patients had a median DFS of 14 months, compared with 125 months in the low-risk group ( < 0.001). : B7-H3 expression serves as a significant prognostic biomarker in localized RCC, correlating with poorer survival outcomes. The integration of B7-H3 into the RIPI enhances risk stratification by incorporating both molecular and pathological features. These findings support the incorporation of immune biomarkers into clinical practice and highlight B7-H3 as a potential target for novel therapeutic strategies in RCC.
肾细胞癌（RCC）是一种生物学上异质性的恶性肿瘤，传统的预后模型往往无法提供准确的风险分层。B7-H3（CD276）是一种免疫检查点分子，与RCC进展有关，但作为一种预后生物标志物仍未得到充分研究。
这项回顾性研究分析了52例接受肾切除术的局限性RCC患者。采用免疫组织化学染色评估B7-H3表达。开发并验证了一种新的预后评分系统——肾免疫预后指数（RIPI），该系统纳入了B7-H3表达、肿瘤坏死、肿瘤分级和病理分期。采用Kaplan-Meier生存分析和Cox比例风险模型评估无病生存期（DFS）和总生存期（OS）。
高B7-H3表达与较短的DFS（12个月对54个月；P = 0.001）和OS（70个月对123个月；P = 0.002）显著相关。RIPI显示出强大的预后性能，将患者分为不同的风险组，C指数为0.82。高危患者的中位DFS为14个月，而低危组为125个月（P < 0.001）。
B7-H3表达是局限性RCC的一个重要预后生物标志物，与较差的生存结果相关。将B7-H3纳入RIPI通过整合分子和病理特征增强了风险分层。这些发现支持将免疫生物标志物纳入临床实践，并突出了B7-H3作为RCC新型治疗策略的潜在靶点。
