Prognostic impact of tumor-associated macrophage infiltration in non-small cell lung cancer: A systemic review and meta-analysis
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Jiandong Mei1,2,*, Zhilan Xiao1,2,*, Chenglin Guo1,2, Qiang Pu1,2, Lin Ma1,2, Chengwu Liu1,2, Feng Lin1,2, Hu Liao1,2, Zongbing You3, Lunxu Liu1,2
1Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
2Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Sichuan University, Chengdu 610041, China
3Department of Structural and Cellular Biology, Tulane University, New Orleans, LA 70112, USA
*These authors contributed equally to this work
Lunxu Liu, email: [email protected]
Zongbing You, email: [email protected]
Keywords: clinicopathological characteristics, non-small cell lung cancer (NSCLC), prognosis, tumor-associated macrophages (TAMs)
Received: February 24, 2016 Accepted: April 11, 2016 Published: April 28, 2016
Tumor-associated macrophages (TAMs) are important components of cancer microenvironment. In the present study, we searched PubMed, Embase, Cochrane library and Web of Science to perform a meta-analysis of 20 studies including a total of 2,572 non-small cell lung cancer (NSCLC) patients, in order to determine the association between TAMs and NSCLC prognosis. The combined hazard ratio (HR) of 9 studies showed that the density of total CD68+ TAMs in the tumor islet and stroma was not associated with overall survival (OS) of the patients. However, the pooled HR of 4 studies showed that high density of CD68+ TAMs in the tumor islet predicted better OS, while the pooled HR of 6 studies showed that high density of CD68+ TAMs in the tumor stroma was associated with poor OS. A high islet/stroma ratio of CD68+ TAMs was associated with better OS. A high density of M1 TAMs in the tumor islet was associated with better OS, while a high density of M2 TAMs in the tumor stroma predicted poor OS. These findings suggest that, although the density of total CD68+ TAMs is not associated with OS, the localization and M1/M2 polarization of TAMs are potential prognostic predictors of NSCLC.
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