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lüll Tumor B7-H1 is associated with poor prognosis in renal cell carcinoma patients with long-term follow-up Thompson RH; Kuntz SM; Leibovich BC; Dong H; Lohse CM; Webster WS; Sengupta S; Frank I; Parker AS; Zincke H; Blute ML; Sebo TJ; Cheville JC; Kwon EDCancer Res 2006[Apr]; 66 (7): 3381-5B7-H1 participates in T-cell costimulation functioning as a negative regulator of immunity. Recent observations suggest that B7-H1 is expressed by renal cell carcinoma (RCC) tumor cells and is associated with poor prognosis. However, outcome analyses have been restricted to patients with fresh-frozen tissue and limited follow-up. We report the clinical effect of B7-H1 in RCC patients with a median of 10 years of follow-up. Between 1990 and 1994, 306 patients underwent nephrectomy for clear cell RCC and had paraffin tissue available for review. We did immunohistochemistry with anti-B7-H1 and conducted outcome analyses. Among the 306 patients, 73 (23.9%) harbored tumors with B7-H1 expression. Patients with tumor B7-H1 were at a significantly increased risk of both death from RCC [risk ratio (RR), 3.92; P < 0.001] and overall mortality (RR, 2.37; P < 0.001). The 5-year cancer-specific survival rates were 41.9% and 82.9% for patients with and without tumor B7-H1, respectively. In a multivariate model, tumor B7-H1 remained associated with cancer-specific death even after adjusting for tumor-node-metastasis stage, grade, and performance status (RR, 2.00; P = 0.003). In the subset of 268 patients with localized RCC, tumor B7-H1 was significantly associated with metastatic cancer progression (RR, 3.46; P < 0.001) and death from RCC (RR, 4.13; P < 0.001) even after adjusting for stage, grade, and performance status (RR, 1.78, P = 0.036). RCC patients with tumor B7-H1 are at significant risk of rapid cancer progression and accelerated rates of mortality. B7-H1 may function as a key determinant in RCC, abrogating immune responses directed against this immunogenic tumor.|Antigens, CD/*biosynthesis/immunology[MESH]|B7-H1 Antigen[MESH]|Carcinoma, Renal Cell/immunology/*metabolism/pathology/surgery[MESH]|Follow-Up Studies[MESH]|Humans[MESH]|Immunohistochemistry[MESH]|Kidney Neoplasms/immunology/*metabolism/pathology/surgery[MESH]|Neoplasm Staging[MESH]|Nephrectomy[MESH]|Prognosis[MESH] |