Yu Peng-Cheng, Long Di, Liao Cheng-Cheng, Zhang Sen
Department of Colorectal Anal Surgery, the First Affiliated Hospital of Guangxi Medical University Department of Chemotherapy, the Affiliated Tumor Hospital of Guangxi Medical University, Nanning, People's Republic of China.
Medicine (Baltimore). 2018 Jul;97(27):e11387. doi: 10.1097/MD.0000000000011387.
Tumor-infiltrating lymphocytes (TILs) have been shown to be of prognostic significance in patients with gastric cancer. This study aims to investigate the association between density of TILs and prognoses of patients with gastric cancer.
The relative studies of tumor-infiltrating lymphocytes in tumor tissue from patients with gastric cancer were systematically searched from PubMed and Embase until October 31, 2017. The pooled hazard ratios (HRs) and their 95% confidence intervals (95%CI) for overall survival (OS) were estimated.
Twenty-nine studies involving 4,942 patients were included into analyses. Subset of TILs included CD8, CD3, CD4, and FOXP3 T cell density. Results from meta-analyses revealed that high density of intratumoral CD8 T cells (HR = 0.77, 95% CI 0.63-0.95) and CD3 (HR = 0.62, 95% CI 0.49-0.77) were associated with significantly higher OS than those with low density in patients with gastric cancer. Moreover, a larger number of general TILs density also suggested a favorable prognosis (HR 0.75, 95% CI 0.67-0.84). However, patients with high density of intratumoral FOXP3 T or CD4 T cells were not statistically associated with higher or lower OS than those with low density (HR 1.41, 95% CI 0.97-2.05; HR = 0.86, 95% CI 0.47-1.57). Sample size and follow-up period seemed to influence study outcomes.
The present study revealed that high density of intratumoral CD8 and CD3 T cells were associated with better OS in patients with gastric cancer.
肿瘤浸润淋巴细胞（TILs）已被证明在胃癌患者中具有预后意义。本研究旨在探讨TILs密度与胃癌患者预后之间的关联。
从PubMed和Embase系统检索截至2017年10月31日的有关胃癌患者肿瘤组织中肿瘤浸润淋巴细胞的相关研究。估计总生存期（OS）的合并风险比（HRs）及其95%置信区间（95%CI）。
纳入分析的有29项研究，共4942例患者。TILs亚群包括CD8、CD3、CD4和FOXP3 T细胞密度。荟萃分析结果显示，与低密度者相比，胃癌患者肿瘤内CD8 T细胞高密度（HR = 0.77，95%CI 0.63 - 0.95）和CD3高密度（HR = 0.62，95%CI 0.49 - 0.77）与显著更高的OS相关。此外，更多的总体TILs密度也提示预后良好（HR 0.75，95%CI 0.67 - 0.84）。然而，肿瘤内FOXP3 T或CD4 T细胞高密度的患者与低密度患者相比，OS无统计学上的高低差异（HR 1.41，95%CI 0.97 - 2.05；HR = 0.86，95%CI 0.47 - 1.57）。样本量和随访时间似乎影响研究结果。
本研究表明，肿瘤内CD8和CD3 T细胞高密度与胃癌患者更好的OS相关。
