Tregs and its correlation with COX-2 expression was also analysed.
RESULTSPeritumoral Tregs were positively correlated with intratumoral COX-2 expression (Spearman rank correlation 0.336, P < 0.001). Peritumoral Tregs were associated with TNM stage ( P = 0.001) and tumour size ( P = 0.002), while intratumoral COX-2 expression was associated with TNM stage ( P = 0.018) and grade ( P = 0.013). Using multivariate analysis, increased peritumoral Tregs, higher TNM stage (III + IV), larger tumour size ( ≥ 7 cm) and higher nuclear grade (III + IV) were independent predictors for significantly shorter overall survival and disease-free survival.
CONCLUSIONSIncreased peritumoral Tregs are associated with worse prognosis in clear cell RCC. The high intratumoral COX-2 expression may be the underlying reason for the aberrant gathering of Tregs. These results suggest that clinical application of COX-2 inhibitors may benefit those patients with higher intratumoral COX-2 immunostaining by reducing the transformation of Tregs in RCC.
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