Abstract
BackgroundTumor associated macrophages (TAMs) have multifaceted roles in the development of many tumor types. However, the prognostic value of TAMs in bladder cancer is still not conclusive.Experimental designThis review evaluated the prognostic value of TAMs density in bladder cancer by reviewing published literatures and integrating the results via a meta-analysis. A systematic search was conducted in PubMed, Embase and Chinese National Knowledge Infrastructure (CNKI), WanFang, and Web of Science databases for relevant studies. Overall survival (OS), relapse free survival (RFS), disease specific survival (DSS), and progression free survival (PFS) were assessed in bladder cancer patients.ResultsThe pooled hazard ratios (HRs) and 95% confidence intervals (CIs) indicated that TAMs identified with CD68 alone have no significant correlation with OS (HR = 1.01, 95% CI = 1.00–1.02), RFS (HR = 0.99, 95% CI = 0.91–1.06), or PFS (HR = 1.19, 95% CI = 0.70–1.68) in bladder cancer patients. Subgroup analyses involved with Bacillus Calmette Guerin (BCG) treatment or sample locations either showed that CD68+ TAMs presented no prognostic value with regard to OS in bladder cancer patients. However, TAMs detected by CD163 are significantly correlated with poor RFS in bladder cancer patients (HR = 1.54, 95% CI = 1.16–1.92).ConclusionsOur data indicated that TAMs identified only with CD68 have no significant correlation with the prognosis and clinicopathological parameters of bladder cancer patients. However, TAMs detected with CD163 could serve as a prognostic marker for bladder cancer patients. These findings invite further research on the role of TAM subsets in bladder cancer patients.
Highlights
Bladder cancer is one of the most common malignant tumors in urological diseases
The pooled hazard ratios (HRs) and 95% confidence intervals (CIs) indicated that Tumor associated macrophages (TAMs) identified with CD68 alone have no significant correlation with Overall survival (OS) (HR = 1.01, 95% CI = 1.00–1.02), relapse free survival (RFS) (HR = 0.99, 95% CI = 0.91–1.06), or progression free survival (PFS) (HR = 1.19, 95% CI = 0.70–1.68) in bladder cancer patients
Subgroup analyses involved with Bacillus Calmette Guerin (BCG) treatment or sample locations either showed that CD68+ TAMs presented no prognostic value with regard to OS in bladder cancer patients
Summary
Bladder cancer is one of the most common malignant tumors in urological diseases. In USA alone, 58950 new cases of bladder cancer and 11820 cases bladder cancer related deaths were estimated in 2016. Transurethral resection of bladder tumor (TURBT) or radical cystectomy (RC) is the primary therapy for NMIBC or MIBC respectively. Following TURBT, bladder instillation of drugs was taken as effective choice to prevent or reduce the recurrence, especially for intermediate and high risk bladder tumors. Bacillus Calmette-Guerin (BCG) intravesical immunotherapy is a classic and effective therapy to inhibit the relapse of intermediate and high risk non-muscleinvasive bladder cancer (NMIBC). Around 39% of NMIBC patients still relapse and 8% will progress to muscle-invasive bladder cancer (MIBC) [3,4,5]. The prognostic value of TAMs in bladder cancer is still not conclusive. Experimental design: This review evaluated the prognostic value of TAMs density in bladder cancer by reviewing published literatures and integrating the results via a metaanalysis. Overall survival (OS), relapse free survival (RFS), disease specific survival (DSS), and progression free survival (PFS) were assessed in bladder cancer patients
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