The present study examined the relationship between tumour stage, grade, T-lymphocyte subset infiltration and survival in patients who had undergone potentially curative surgery for renal clear-cell cancer (n ¼ 73). Intratumoural CD4 þ T-lymphocyte infiltrate was associated with poor cancer-specific survival, independent of grade, in this cohort. British Journal of Cancer (2003Cancer ( ) 89, 1906Cancer ( -1908 Local and systemic inflammatory responses are regulated through the production of proteins, such as cytokines, by immunologically active cells. In cancer, this mechanism is disturbed by the presence of the tumour and this dysregulation may contribute to the poorer outcome in the cancer patient (Balkwill and Mantovani, 2001).Recent work has suggested that the presence of specific Tlymphocyte subsets has prognostic value in a number of solid tumours. Naito et al (1998) demonstrated that increased numbers of CD8 þ T lymphocytes in the tumour were associated with better survival in patients with colorectal cancer.There has been little work carried out in renal cancer and the results appear to be different from other solid tumours. Kolbeck et al (1992) in a small study reported that increased tumour T-cell infiltration was associated with increased tumour recurrence. More recently, in a larger series, it has been reported that increased numbers of CD8 þ T lymphocytes in the tumour are associated with poor survival in patients with renal cancer (Nakano et al, 2001).The aim of the present study was to examine the relationship between tumour stage, grade, T-lymphocyte subset infiltration and survival in patients who had undergone potentially curative surgery for renal clear-cell cancer.
PATIENTS AND METHODS
PatientsPatients with histologically proven renal clear-cell cancer that, on the basis of preoperative CT-scan of the abdomen and chest and pathological assessment of the resected tumour, were considered to have undergone potentially curative surgery between July 1997 and December 2000 in the North Glasgow NHS Trust were included in the study. Pathological staging was based on TNM and classified as pII or 4II (Guinan et al, 1997).The study was approved by the local ethical committee.
ImmunohistochemistryBlocks from the primary tumour were fixed in 10% buffered formalin and embedded in paraffin wax. One representative block of tumour was selected for each patient. Sections (4 mm) were cut and mounted on slides coated with aminopropyltriethoxysilane. Sections were then immunostained using the peroxidase-based Envision (Dako, Cambridgeshire, UK) technique. The primary antibody for CD4 was mouse monoclonal (Vector, Peterborough, UK) and that for CD8 was mouse monoclonal (Dako, Cambridgeshire, UK). Sections were dewaxed and rehydrated. Endogenous peroxidase was blocked by incubation in 0.3% hydrogen peroxide for 10 min. Antigen retrieval for CD8 was performed by microwaving in 1 mM EDTA buffer, pH 8, for 5 min at full pressure in aplastic pressure cooker in a microwave oven. Antigen retrieval for CD4 was achieved b...
