Meta-Analysis:
Prognostic role of tumor-infiltrating lymphocytes in gastric cancer: a meta-analysis
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Abstract
Xiao Zheng1,2,3,*, Xing Song4,*, Yingjie Shao4, Bin Xu1,2,3, Lujun Chen1,2,3, Qi Zhou5, Wenwei Hu5, Dachuan Zhang6, Changping Wu1,2,5, Min Tao3, Yibei Zhu3 and Jingting Jiang1,2,3
1Department of Tumor Biological Treatment, The Third Affiliated Hospital of Soochow University, Changzhou 213003, People’s Republic of China
2Jiangsu Engineering Research Center for Tumor Immunotherapy, Changzhou 213003, People’s Republic of China
3Institute of Cell Therapy, Soochow University, Changzhou 213003, People’s Republic of China
4Department of Radiation Oncology, The Third Affiliated Hospital of Soochow University, Changzhou 213003, People’s Republic of China
5Department of Oncology, The Third Affiliated Hospital of Soochow University, Changzhou 213003, People’s Republic of China
6Department of Pathology, The Third Affiliated Hospital of Soochow University, Changzhou 213003, People’s Republic of China
*These authors have contributed equally to this work
Correspondence to:
Jingting Jiang, email: [email protected]
Keywords: TILs, prognosis, gastric cancer, biomarker, meta-analysis
Received: February 28, 2017 Accepted: April 26, 2017 Published: May 22, 2017
ABSTRACT
Background: In patients with gastric cancer, the prognostic value of tumor-infiltrating lymphocytes (TILs) is still controversial. A meta-analysis was performed to evaluate the prognostic value of TILs in gastric cancer.
Materials and methods: We identify studies from PubMed, Embase and the Cochrane Library to assess the prognostic effect of TILs in patients with gastric cancer. Fixed-effects models or random-effects models were used estimate the pooled hazard ratios (HRs) for overall survival (OS) and disease-free survival (DFS), which depend on the heterogeneity.
Results: A total of 31 observational studies including 4,185 patients were enrolled. For TILs subsets, the amount of CD8+, FOXP3+, CD3+, CD57+, CD20+, CD45RO+, Granzyme B+ and T-bet+ lymphocytes was significantly associated with improved survival (P < 0.05); moreover, the amount of CD3+ TILs in intra-tumoral compartment (IT) was the most significant prognostic marker (pooled HR = 0.52; 95% CI = 0.43–0.63; P < 0.001). However, CD4+ TILs was not statistically associated with patients’ survival. FOXP3+ TILs showed bidirectional prognostic roles which had positive effect in IT (pooled HR = 1.57; 95% CI = 1.04–2.37; P = 0.033) and negative effect in extra-tumoral compartment (ET) (pooled HR = 0.76; 95% CI = 0.60–0.96; P = 0.022).
Conclusions: This meta-analysis suggests that some TIL subsets could serve as prognostic biomarkers in gastric cancer. High-quality randomized controlled trials are needed to decide if these TILs could serve as targets for immunotherapy in gastric cancer.
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