title: The prognostic value of FOXP3+ T regulatory cells in colorectal cancer.
abstract: OBJECTIVE
  The evaluation of CD3(+) T-cell density is believed to have a higher prognostic value than the conventionally used TMN stage in colorectal cancer (CRC), but the role of regulatory T lymphocytes (Treg) is still debated. Our study determined the prognostic value of forkhead box P3 nuclear transcription factor (FOXP3) positive Treg and CD3(+) T-cells in the invasive margin of CRC compared with other known prognostic factors.
  
  
  METHODS
  The prognostic factors analysed in 42 patients with CRC stage II (N=13) and III (N=29), were age, tumor location, TNM stage, histological grade, vascular, lymphatic and perineural invasion. CD3(+) T-cells and FOXP3(+) Treg density was evaluated by immunohistochemistry.
  
  
  RESULTS
  The median CD3(+) T-cells and FOXP3(+) Treg density was 438.93/mm(2) and 162.25/mm(2), respectively. Patients with high FOXP3(+) Treg density showed improved 5-year survival rate of 89.41%, compared with 64.6% of those with low density (p=0.024).
  
  
  CONCLUSIONS
  Increased CD3(+) T-cells and FOXP3(+) Treg density is associated with improved survival, but only the latter proved to be an independent prognostic factor. FOXP3(+) Treg infiltrate may play an important prognostic role, which, in combination with other predictive factors, could lead to the development of specific treatment regimens.
authors.affiliation: Department of Surgical and Gynecological Oncology, Ion Chiricuta Institute of Oncology, Cluj-Napoca, Romania.
authors.forename: Catalin
authors.initials: C
authors.lastname: Vlad
authors.forename: Paul
authors.initials: P
authors.lastname: Kubelac
authors.forename: Bogdan
authors.initials: B
authors.lastname: Fetica
authors.forename: Diana
authors.initials: D
authors.lastname: Vlad
authors.forename: Alexandru
authors.initials: A
authors.lastname: Irimie
authors.forename: Patriciu
authors.initials: P
authors.lastname: Achimas-Cadariu
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis*; D017252:CD3 Complex / Q000032:analysis; D015179:Colorectal Neoplasms / Q000276:immunology* / Q000401:mortality / Q000473:pathology / Q000628:therapy; D005260:Female; D051858:Forkhead Transcription Factors / Q000032:analysis*; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D050378:T-Lymphocytes, Regulatory / Q000276:immunology*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D017252:CD3 Complex; C418974:FOXP3 protein, human; D051858:Forkhead Transcription Factors