Prognostic Role of Tumor-Infiltrating Lymphocytes in Esophagus Cancer: a Meta-Analysis

Abstract

Background/Aims: Several studies have verified the correlation between tumor-infiltrating lymphocytes (TILs) and survival of patients with esophagus cancer (EC). However, the prognostic role of TILs is still controversial. Therefore, we performed this meta-analysis. Methods: We searched PubMed, Embase and the Cochrane Library (last update by August 30, 2017) to identify studies assessing the effect of TILs on survival of patients with EC. Pooled hazard ratios (HRs) for overall survival (OS), disease-free survival (DFS) and cancer specific survival (CSS) were estimated using fixed-effects models or random-effects models, which depends on the heterogeneity. Results: Data from 22 observational studies including 2909 patients were summarized. Pooled analysis indicated that generalized TILs were favorable prognostic markers for OS in patients with EC (pooled HR = 0.48; 95% CI = 0.38-0.61; P < 0.001). For TIL subsets, CD8⁺ TILs were associated with improved OS (pooled HR = 0.68; 95% CI = 0.58–0.84; P < 0.001) and DFS (pooled HR = 0.90; 95% CI = 0.85-0.95; P < 0.001); FoxP3⁺ TILs were associated with patients’ DFS (pooled HR = 0.88; 95% CI = 0.81-0.96; P = 0.003). High CD57⁺ TILs indicated a better OS in patients with EC (pooled HR = 0.50; 95% CI = 0.35-0.72; P < 0.001). In addition, the pooled results showed that other TIL subsets including CD3⁺, CD4⁺ and CD45RO⁺ TILs were not associated with patients’ survival (P > 0.05). Conclusions: For patients with EC, some TIL subsets could serve as prognostic biomarkers. The application of TILs in the immunotherapy of EC needs to be verified through a large amount of clinical research.

High CD169 expression in lymph node macrophages predicts a favorable clinical course in patients with esophageal cancer

“…In colorectal cancer, it has long been known that a high density of TILs is associated with a better clinical course, and recent findings of a meta‐analysis of 250 published articles indicated a similar association . A meta‐analysis of 22 studies indicated that patients with a high density of TILs showed a significantly more‐favorable clinical course in esophageal cancer patients . In this study, we demonstrated that a high density of TILs is associated with better clinical course in patients who underwent pretreatment.…”

“…31 A meta-analysis of 22 studies indicated that patients with a high density of TILs showed a significantly more-favorable clinical course in esophageal cancer patients. 32 In this study, we demonstrated that a high density of TILs is associated with better clinical course in patients who underwent pretreatment. Therefore, we propose that the immunoscore of TILs would be particularly useful for predicting the clinical course in patients undergoing pretreatment.…”

Association Between Pretreatment Serum Apolipoprotein A1 and Prognosis of Solid Tumors in Chinese Population: A Systematic Review and Meta-Analysis

“…First, several individual HRs were obtained from univariate analysis, which have not adjusted the confounding factors and might overestimate the effect size [58]. Second, due to no acknowledged threshold, the cut-off values for defining “high” level of apoA1 were extremely different among the included studies, which might affect the availability of serum apoA1 as a prognostic biomarker in malignances.…”

Alcohol intake, tobacco smoking, and esophageal adenocarcinoma survival: a molecular pathology epidemiology cohort study

“…Several studies in breast cancer have not shown any association between alcohol consumption and HER2 receptor expression [22] and to date, no studies have reported on the impact of cigarette smoking or alcohol consumption on GLUT1 expression in any type of cancer. A higher CD8+ tumor expression in esophageal adenocarcinoma has been shown to be associated with a significantly improved overall survival [23]. Despite these findings, no previous studies have investigated the impact of smoking or alcohol consumption on esophageal adenocarcinoma survival according to strata of these biomarkers, which is an important consideration for future precision medicine initiatives.…”