Abstract
BackgroundActivated eosinophils have been deemed to affect carcinogenesis and tumor progression via various mechanisms in tumor microenvironment. However, the prognostic role of tumor-associated tissue eosinophilia (TATE) in human cancers remains controversial. Therefore, we conducted this meta-analysis to better comprehend the association between TATE and clinical outcomes of patients.MethodsWe searched PubMed, Embase and EBSCO to determine the researches assessing the association between TATE and overall survival (OS) and/or disease-free survival (DFS) in patients with cancer, then combined relevant data into hazard ratios (HRs) or odds ratio (OR) for OS, DFS and clinicopathological features including lymph node metastasis etc. with STATA 12.0.ResultsTwenty six researches with 6384 patients were included in this meta-analysis. We found that the presence of TATE was significantly associated with improved OS, but not with DFS in all types of cancers. In stratified analyses based on cancer types, pooled results manifested that the infiltration of eosinophils was remarkably associated with better OS in esophageal carcinoma and colorectal cancer. In addition, TATE significantly inversely correlated with lymph node metastasis, tumor stage and lymphatic invasion of cancer.ConclusionTATE promotes survival in cancer patients, suggesting that it is a valuable prognostic biomarker and clinical application of biological response modifiers or agonists promoting TATE may be the novel therapeutic strategy for patients.
Highlights
Activated eosinophils have been deemed to affect carcinogenesis and tumor progression via various mechanisms in tumor microenvironment
All the researches were scored 6 or above after careful evaluation with the Newcastle– Ottawa Scale (NOS); Characteristics of those researches being in the light of the inclusion criteria and suitable for data incorporation were exhibited in Table 1 and Table S1
Meta-analyses Overall survival (OS) In this meta-analysis, we discovered that the presence of tumor-associated tissue eosinophilia (TATE) was notably associated with improved overall survival (OS) (HR = 0.82, 95% confidence interval (CI) 0.68 to 0.99, P = 0.041) in patients with solid tumor. (Fig. 1)
Summary
Search strategy This meta-analysis was guided by the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) Statement issued in 2009 (Checklist S1). Inclusion and exclusion criteria Researches included in this meta-analysis should meet the following inclusion criteria: (1) been published as original articles; (2) investigated human subjects; (3) examined eosinophils in primary tumor tissues; (4) reported hazard ratios (HRs) with 95% confidence interval (CI), or Kaplan – Meier curves of eosinophil infiltration with clinical outcomes. The exclusion criteria were as follows: researches (1) were not published as research articles or full texts including commentaries, case reports, letters to the editors and meeting abstracts; (2) didn’t offer ample data to obtain HRs; (3) investigated eosinophils in metastases or not in tumor tissues. OS, DFS and clinicopathological features such as tumor, node, metastasis (TNM) stage and lymphatic invasion were extracted from the text, tables, or Kaplan – Meier curves. Statistical analysis We combined extracted data using STATA 12.0 analysis software, and estimated statistical heterogeneity with the
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