title: Clinicopathological and prognostic significance of FOXP3+ tumor infiltrating lymphocytes in patients with breast cancer: a meta-analysis.
abstract: BACKGROUND
  The prognostic significance of FOXP3+ tumor-infiltrating lymphocytes (TILs) in patients with breast cancer remains controversial. The aims of our meta-analysis are to evaluate its association with clinicopathological characteristics and prognostic significance in patients with breast cancer.
  
  
  METHODS
  PubMed, Embase, Cochrane Database and the Ovid Database were systematically searched (up to April 2015). The meta-analysis was performed using hazard ratio (HR), odds ratio (OR) and 95 % confidence intervals (CI) as effect measures. Using the random-effects model, statistical analysis was performed using Stata software, version 12.0.
  
  
  RESULTS
  Seventeen studies including 8277 patients with breast cancer were analyzed. The meta-analysis indicated that the incidence difference of FOXP3+ TILs was significant when comparing the lymph node positive group to negative group (OR = 1.305, 95 % CI [1.071, 1.590]), the histological grade III group to the I-II group (OR = 3.067, 95 % CI [2.288, 4.111]), the ER positive group to the negative group (OR = 0.435, 95 % CI [0.287, 0.660]), the PR positive group to the negative group (OR = 0.493, 95 % CI [0.296, 0.822]), the HER2 positive group to the negative group (OR = 1.896, 95 % CI [1.335, 2.692]), the TNBC group to the non TNBC group (OR = 2.456, 95 % CI [1.801, 3.348]). The detection of FOXP3+ TILs was significantly correlated with the recurrence-free survival (RFS) of patients (HR = 1.752, 95 % CI [1.188-2.584]) and the overall survival (OS) of patients (HR =1.447, 95 % CI [1.037-2.019]).
  
  
  CONCLUSIONS
  Our meta-analysis demonstrates that the presence of high levels of FOXP3+ TILs is associated with prognosis for breast cancer patients and predicts lymph node metastasis, hormone receptor and HER-2 status.
authors.affiliation: Department of Breast Surgery, Liaoning Province Cancer Hospital and Institute, Shenyang, Liaoning, 110042, People's Republic of China. goozh3066@sina.cn.|Department of Surgical Oncology, the First Affiliated Hospital, School of Medicine of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi Province, China. goozh3066@sina.cn.
authors.forename: Daqing
authors.initials: D
authors.lastname: Jiang
authors.affiliation: Department of Breast Surgery, Liaoning Province Cancer Hospital and Institute, Shenyang, Liaoning, 110042, People's Republic of China. gooscigol@163.com.|Department of Breast Surgery, Dalian Medical University Clinical Oncology College, Shenyang, Liaoning, 110042, China. gooscigol@163.com.
authors.forename: Zhaohua
authors.initials: Z
authors.lastname: Gao
authors.affiliation: Department of Breast Surgery, the First Affiliated Hospital, Dalian Medical University, Dalian, Liaoning, 116011, China. googlegao@163.com.
authors.forename: Zhengang
authors.initials: Z
authors.lastname: Cai
authors.affiliation: Department of Tumour Pathology and Surgical Oncology, First Hospital of China Medical University, Shenyang, 110001, China. lnchwang@126.com.
authors.forename: Meixian
authors.initials: M
authors.lastname: Wang
authors.affiliation: Department of Surgical Oncology, the First Affiliated Hospital, School of Medicine of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi Province, China. pleasure95@163.com.
authors.forename: Jianjun
authors.initials: J
authors.lastname: He
mesh_terms: D014408:Biomarkers, Tumor / Q000096:biosynthesis* / Q000276:immunology; D001943:Breast Neoplasms / Q000235:genetics* / Q000276:immunology / Q000473:pathology; D018572:Disease-Free Survival; D005260:Female; D051858:Forkhead Transcription Factors / Q000096:biosynthesis* / Q000276:immunology; D006801:Humans; D008207:Lymphatic Metastasis; D016246:Lymphocytes, Tumor-Infiltrating / Q000276:immunology / Q000473:pathology*; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000235:genetics
chemical_list: D014408:Biomarkers, Tumor; D051858:Forkhead Transcription Factors; D018719:Erb-b2 Receptor Tyrosine Kinases; C418974:FOXP3 protein, human; C508053:ERBB2 protein, human