J Cancer 2020; 11(11):3340-3348. doi:10.7150/jca.42472 This issue

Research Paper

The Proportion and Prognostic Significance of T-Regulatory Cells in Patients with Gynecological Cancers: A Systematic Review and Meta-Analysis

Jiali Hu, Xirong Wu, Pengzhu Huang, Fei Teng, Yingmei Wang, Fengxia Xue

Department of Obstetrics and Gynecology, Tianjin Medical University General Hospital, 154 Anshan Road, He Ping District, Tianjin 300052, China.

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Citation:
Hu J, Wu X, Huang P, Teng F, Wang Y, Xue F. The Proportion and Prognostic Significance of T-Regulatory Cells in Patients with Gynecological Cancers: A Systematic Review and Meta-Analysis. J Cancer 2020; 11(11):3340-3348. doi:10.7150/jca.42472. Available from https://www.jcancer.org/v11p3340.htm

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Abstract

Objective: Multiple reports have described the proportion of T-regulatory cells (Tregs) in peripheral blood (PB) and tissues in patients with gynecological cancers (GCs) with controversial results. Thus, the aim of this study was to investigate the proportion of Tregs and its prognostic survival role in GCs patients.

Methods: We performed a comprehensive search from database inception for all studies presenting changes of Tregs in GCs patients versus controls to evaluate the pooled standardized mean differences (SMD) with 95% confidence intervals (95% CI). And hazard ratios (HRs) with 95% CI were recorded if available to determine the prognostic significance of Tregs.

Results: Totally, 22 studies were included. Compared with controls, GCs patients had a higher proportion of Tregs in PB (SMD = 2.32, 95% CI = 1.47 to 3.17, P = 0.000) as well as in tissues (SMD = 3.47, 95% CI = 0.77 to 6.18, P = 0.012). Furthermore, more significant elevated frequency of Tregs was observed in GCs patients with advanced stage than those in the early stage in both PB and tissues. However, no association was found between Tregs and survival of GCs patients with an HR of 1.34 (95% CI = 0.96 to 1.88, P = 0.09).

Conclusions: Compared to controls, proportion of Tregs in PB and tissues was both higher among GCs patients, and it can be considered as a clinical biomarker for screening and prediction of clinical characteristics of GCs patients. But larger researches with rigorous design should be carried to explore the deep mechanisms of Tregs in GCs.

Keywords: Gynecological cancer, T-regulatory cell, Proportion, Prognosis, Meta-analysis