Abstract
BackgroundTumor-infiltrating lymphocytes (TILs) are major participants in the tumor microenvironment. The prognostic value of TILs in patients with pancreatic cancer is still controversial.MethodsThe aim of our meta-analysis was to determine the impact of FoxP3+Treg cells on the survival of pancreatic cancer patients. We searched for related studies in PubMed, EMBASE, Ovid, and Cochrane Library from the time the databases were established to Mar 30, 2017. We identified studies reporting the prognostic value of FoxP3+Treg cells in patients with pancreatic cancer. Overall survival (OS) and disease-free survival (DFS)/progression-free survival (PFS)/relapse-free survival (RFS) were investigated by pooling the data. The pooled hazard ratios (HRs) with 95% confidence intervals (95% CI) were used to evaluate the association between FoxP3+Treg cells and survival outcomes of pancreatic cancer patients. A total of 972 pancreatic cancer patients from 8 studies were included in our meta-analysis.ResultsHigh levels of infiltration with FoxP3+Treg cells were significantly associated with poor OS (HR=2.13; 95% CI 1.64–2.77; P<0.05) and poor DFS/PFS/RFS (HR=1.70; 95% CI 1.04 ~ 2.78; P< 0.05). Similar results were also observed in the peritumoral tissue; high levels of FoxP3+Treg cells were associated with poor OS (HR =2.1795% CI, CI 1.50–3.13).ConclusionThis meta-analysis indicated that high levels of intratumoral or peritumoral FoxP3+Treg cell infiltration could be recognized as a negative factor in the prognosis of pancreatic cancer.
Highlights
Pancreatic cancer, pancreatic ductal adenocarcinoma (PDAC), is one of the most malignant cancers, with a 5-year survival rate of only 7% [1]
We found that there was a need to summarize a large sample size of tumors to determine the association between tumor-infiltrating FoxP3+Treg cells and prognosis in pancreatic cancer in order to gain insight into whether FoxP3+Treg cells can provide useful guidance for the biological treatment of pancreatic cancer
A total of 972 patients with pancreatic cancer were enrolled in these studies
Summary
Pancreatic cancer, pancreatic ductal adenocarcinoma (PDAC), is one of the most malignant cancers, with a 5-year survival rate of only 7% [1]. TILs have been reported in a variety of tumors, including pancreatic cancer, but the mechanism of interaction between TILs and the tumor is very complex and still unclear. Previous studies have shown that CD8+ T cell infiltration of tumors is a beneficial factor in patients with colorectal cancer [7, 8], ovarian cancer [9], lung cancer [10], and pancreatic cancer. It is confirmed that the role of CD4+ T cell infiltration is more complex in tumor progression. Tumor-infiltrating lymphocytes (TILs) are major participants in the tumor microenvironment. The prognostic value of TILs in patients with pancreatic cancer is still controversial
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