Abstract
The prognostic and clinicopathological value of regulatory T cells (Tregs) infiltration in patients with non-small cell lung cancer (NSCLC) remains undetermined. A comprehensive literature search of electronic databases (up to December 2015) was conducted. Relationship between Tregs infiltration and clinicopathological features, recurrence-free survival (RFS) and overall survival (OS) was investigated by synthesizing the qualified data. A total of 1303 NSCLC patients from 11 studies were included. The pooled hazard ratio (HR) for survival showed that high Tregs infiltration had no effect on RFS (HR = 2.03, 95% CI: 0.61–3.44, P = 0.708) and OS (HR = 1.20, 95% CI: 0.58–1.62, P = 0.981). High FoxP3+ Tregs infiltration was significantly associated with poor OS in NSCLC (HR = 3.88, 95% CI: 2.45–5.40, P = 0.000). Test methods, ethnicity and types of specimens had no effect on predicting prognosis of Tregs infiltration. While high Tregs infiltration was significantly correlated with smoking status [odds ratios (ORs) = 1.54, 95% CI: 1.15–2.08; P = 0.004], none of other clinicopathological characteristics such as gender, histological type, lymph node metastasis status, tumor size, vascular invasion, lymphatic invasion and pleural invasion were associated with Tregs infiltration. The present study demonstrated that high FoxP3+ Tregs infiltration was significantly associated with poor prognosis in NSCLC and smoking status.
Highlights
Lung cancer is the most common malignant tumor and the leading cause of cancer death worldwide, with 1.6 million new cases and 1.38 million deaths annually [1, 2]
The pooled hazard ratio (HR) for survival showed that high Tregs infiltration had no effect on recurrence-free survival (RFS) (HR = 2.03, 95% confidence intervals (CIs): 0.61–3.44, P = 0.708) and overall survival (OS) (HR = 1.20, 95% CI: 0.58–1.62, P = 0.981)
While high Tregs infiltration was significantly correlated with smoking status [odds ratios (ORs) = 1.54, 95% CI: 1.15–2.08; P = 0.004], none of other clinicopathological characteristics such as gender, histological type, lymph node metastasis status, tumor size, vascular invasion, lymphatic invasion and pleural invasion were associated with Tregs infiltration
Summary
Lung cancer is the most common malignant tumor and the leading cause of cancer death worldwide, with 1.6 million new cases and 1.38 million deaths annually [1, 2]. Non-small cell lung cancer (NSCLC) accounts for 80–85% of all lung malignancies and the overall 5-year survival of patients with NSCLC remains approximately 15–20% [3, 4]. The driver mutations including epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) have revolutionized the treatment and prognosis of NSCLC, it just focused on the cancer cell intrinsic properties [5, 6]. More and more recent studies have begun to investigate the prognostic and clinicopathological role of tumor microenvironment (TME) in NSCLC [7, 8]. Increasing evidence indicates that inhibitory function plays the crucial role in the TME [6, 9]. One of the most significant inhibitory components is the regulatory T cells (Tregs)
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