Department of Medical Writing, Catalyst Clinical Research, 2528 Independence Blvd, Suite 100, Wilmington, NC, 28412, USA.
Department of Biological Sciences, Birla Institute of Technology and Science, Pilani-Hyderabad Campus, Jawahar Nagar, Shameerpet Mandal, Hyderabad, Telangana, 500078, India.
Syst Rev. 2024 Sep 14;13(1):233. doi: 10.1186/s13643-024-02642-w.
Tumour, nodes, and metastases (TNM) staging has been deficient in prognosticating in patients suffering from non-small cell lung cancer (NSCLC). To supplement TNM staging, this systematic review and meta-analysis aimed to evaluate the prognostic value of the regulatory T cells (Treg).
A keyword search was conducted in MEDLINE and EMBASE for full-text original human studies from any region published in English during the last 12 years. Eligible for inclusion were studies evaluating the prognostic value of the number of Treg cells in NSCLC except case studies, case series, systematic reviews, and meta-analyses. Two reviewers (one reviewer used an automation tool) independently screened the studies and assessed risk-of-bias using the Quality in Prognosis Studies (QUIPS) tool. Meta-analysis was done for studies reporting significant multivariate hazard ratio (HR).
Out of 809 retrievals, 24 studies were included in the final review. The low number of Treg cells was found significantly associated with improved overall survival (pooled log OR, 1.646; 95% CI, 1.349, 1.944; p (2-tailed) < .001; SE, 0.1217), improved recurrence-free survival (HR, 1.99; 95% CI, 1.15, 3.46; p = .01), improved progression-free survival (pooled log OR, 2.231; 95% CI, 0.424, 4.038; p (2-tailed) .034; SE, 0.4200), and worse disease-free survival (pooled log OR, 0.992; 95% CI, 0.820, 1.163; p (2-tailed) .009; SE, 0.0135), especially when identified by forkhead box P3 (FOXP3), in any stage or non-metastatic NSCLC.
A low number of Treg cells indicated better survival, suggesting its potential use as a prognostic biomarker in NSCLC.
The protocol of this review was prospectively registered on PROSPERO on August 28, 2021, and was assigned the registration number CRD42021270598. The protocol can be accessed from PROSPERO website.
肿瘤、淋巴结和转移（TNM）分期在预测非小细胞肺癌（NSCLC）患者的预后方面存在不足。为了补充 TNM 分期，本系统评价和荟萃分析旨在评估调节性 T 细胞（Treg）的预后价值。
在 MEDLINE 和 EMBASE 中进行了关键词搜索，以获取过去 12 年内在任何地区以英文发表的全文原始人类研究。纳入标准为评估 NSCLC 中 Treg 细胞数量的预后价值的研究，除病例研究、病例系列、系统评价和荟萃分析外。两名审查员（一名审查员使用自动化工具）独立筛选研究，并使用预后研究质量（QUIPS）工具评估偏倚风险。对报告显著多变量风险比（HR）的研究进行荟萃分析。
在 809 项检索结果中，最终综述纳入了 24 项研究。低数量的 Treg 细胞与改善的总生存期显著相关（合并对数优势比，1.646；95%置信区间，1.349，1.944；p（双侧）<0.001；SE，0.1217），改善无复发生存率（HR，1.99；95%置信区间，1.15，3.46；p=0.01），改善无进展生存期（合并对数优势比，2.231；95%置信区间，0.424，4.038；p（双侧）0.034；SE，0.4200），改善无病生存期（合并对数优势比，0.992；95%置信区间，0.820，1.163；p（双侧）0.009；SE，0.0135），尤其是在任何分期或非转移性 NSCLC 中通过叉头框 P3（FOXP3）鉴定时。
Treg 细胞数量较少表明生存情况较好，提示其可能作为 NSCLC 的预后生物标志物。
本综述的方案于 2021 年 8 月 28 日在 PROSPERO 上进行了前瞻性注册，并被分配了注册号 CRD42021270598。可从 PROSPERO 网站获取该方案。
