Prognostic effect of comorbid disease and immune gene expression on mortality in kidney cancer—a population based study

Chung Shun Wong, Tzu Ting Chen, Wei Pin Chang, Henry Sung Ching Wong, Mei Yi Wu, Wirawan Adikusuma, Yuh Feng Lin, Wei Chiao Chang

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Article number1654
Pages (from-to)1-13
Number of pages13
JournalCancers
Volume12
Issue number6
DOIs
Publication statusPublished - Jun 2020

Keywords

  • Comorbidity
  • Immune metagenes
  • Kidney cancer
  • Renal cell carcinoma
  • Survival

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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