Department of General Surgery, the First Affiliated Hospital of Jinan University, Guangzhou 510632, China.
International School, Jinan University, Guangzhou 510632, China.
Int J Med Sci. 2021 Apr 7;18(11):2327-2338. doi: 10.7150/ijms.56347. eCollection 2021.
An increasing number of studies had shown that tertiary lymphoid structure (TLS) plays an important role in tumor progression. However, the prognostic role of TLS in various tumors remains controversial. This meta-analysis aims to investigate the clinicopathological and prognostic values of TLS in solid tumors. A systematic search was conducted in PubMed, EMBASE and Cochrane Library undated to November 2, 2020. Odds ratios of clinical parameters, hazard ratio (HR) of overall survival (OS), relapse-free survival (RFS), disease-free survival (DFS) and relapse rate were calculated in order to evaluate the relationship between TLS expression and clinicopathological or prognostic values in different tumors. 27 eligible studies including 6647 patients with different types of tumors were analyzed. High TLS expression was associated with a longer OS (HR = 0.66, 95% CI: 0.50 - 0.86, = 0.002) and RFS (HR = 0.61, 95% CI: 0.47 - 0.79, = 0.0001). Moreover, high TLS levels in tumor were associated with a low risk of recurrence (HR = 0.43, 95% CI: 0.32 - 0.57, < 0.0001). However, there was no relationship between TLS expression and DFS. Meanwhile, high TLS expression was associated with smaller tumor size ( < 0.00001) and higher tumor infiltrating lymphocytes (TILs). Furthermore, the subgroup analysis showed high TLS expression that may be associated with a lower clinical grading and N stage in breast cancer and colorectal cancer. High TLS expression is associated with the longer OS and RFS in solid tumors, and a lower risk of cancer relapse. Meanwhile, high TLS expression is also associated with a smaller tumor size, higher infiltration of TILs, lower clinical grading and N stage in the tumor. Therefore, high TLS expression in the tumor is a favorable prognostic biomarker for solid tumor patients.
越来越多的研究表明,三级淋巴结构(TLS)在肿瘤进展中起着重要作用。然而,TLS 在各种肿瘤中的预后作用仍存在争议。本荟萃分析旨在探讨 TLS 在实体瘤中的临床病理和预后价值。系统检索了 PubMed、EMBASE 和 Cochrane Library 截至 2020 年 11 月 2 日的文献。计算了临床参数的优势比、总生存期(OS)、无复发生存期(RFS)、无病生存期(DFS)和复发率的风险比(HR),以评估 TLS 表达与不同肿瘤的临床病理或预后价值之间的关系。分析了 27 项符合条件的研究,共纳入 6647 例不同类型肿瘤患者。TLS 高表达与 OS(HR=0.66,95%CI:0.50-0.86, = 0.002)和 RFS(HR=0.61,95%CI:0.47-0.79, = 0.0001)较长相关。此外,肿瘤中 TLS 水平较高与复发风险较低相关(HR=0.43,95%CI:0.32-0.57, < 0.0001)。然而,TLS 表达与 DFS 之间无相关性。同时,TLS 表达与肿瘤体积较小( < 0.00001)和肿瘤浸润淋巴细胞(TILs)较多相关。此外,亚组分析显示,TLS 高表达可能与乳腺癌和结直肠癌的临床分级和 N 分期较低有关。TLS 高表达与实体瘤的 OS 和 RFS 较长以及癌症复发风险较低相关。同时,TLS 表达也与肿瘤体积较小、TILs 浸润较多、肿瘤临床分级和 N 分期较低有关。因此,肿瘤中 TLS 高表达是实体瘤患者的有利预后生物标志物。