title: Worse outcome in breast cancer with higher tumor-infiltrating FOXP3+ Tregs : a systematic review and meta-analysis.
abstract: Forkhead box P3(FOXP3) is known as the optimum maker for regulatory T cells(Tregs), which are conventionally thought to induce immune tolerance to disturb the antitumor immunity. However, the research on the prognostic significance of tumor-infiltrating FOXP3+ Tregs in breast cancer is still limited and the results are controversial.
  
  
  
  We searched for studies in PubMed, EMBASE and Web of Science prior to January 2015. The correlation between FOXP3+ tumor-infiltrating lymphocytes(TILs) and breast cancer prognosis was analyzed. The meta-analysis was performed using STATA 11.0. Pooled hazard ratios (HRs) with 95 % confidence intervals (CIs) were used to estimate the degree of the association between FOXP3+ TILs and prognosis of breast cancers, while relative ratios (RRs) were used to evaluate the relationship between FOXP3+ TILs and clinicopathological features of breast cancers.
  
  
  
  A total of 15 studies comprising 8666 breast cancer patients met the inclusion criteria. Our results showed that higher FOXP3+ TILs level was significantly associated with poor prognosis in terms of overall survival (OS) (pooled HR:1.60, 95 % CI:1.06-2.42; P < 0.05). We found that breast cancer with higher FOXP3+ TILs level was positively correlated with c-erbB-2 positive status (pooled RR:1.52, 95 % CI:1.32-1.75; P < 0.05), lymph node positive status(pooled RR:1.17, 95 % CI:1.04-1.32; P < 0.05) while there was a negative association with ER positive status(pooled RR:0.65, 95 % CI:0.56-0.76; P < 0.05) and PR positive status(pooled RR:0.66, 95 % CI:0.51-0.87; P < 0.05).
  
  
  
  The present results of meta-analysis showed that higher FOXP3+ TILs level in patients with breast cancer led to poor overall survival (OS) and was significantly associated with c-erbB-2 status, lymph node status, ER status and PR status. FOXP3+ TILs level is a promising prognostic factor in breast cancer.
authors: Cancer Institute (Key Laboratory of Cancer Prevention and Intervention, National Ministry of Education, Provincial Key Laboratory of Molecular Biology in MedicalSciences), The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 31009, China.
authors: Jiafeng
authors: J
authors: Shou
authors: Cancer Institute (Key Laboratory of Cancer Prevention and Intervention, National Ministry of Education, Provincial Key Laboratory of Molecular Biology in MedicalSciences), The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 31009, China.
authors: Zhigang
authors: Z
authors: Zhang
authors: Cancer Institute (Key Laboratory of Cancer Prevention and Intervention, National Ministry of Education, Provincial Key Laboratory of Molecular Biology in MedicalSciences), The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 31009, China.
authors: Yucheng
authors: Y
authors: Lai
authors: Cancer Institute (Key Laboratory of Cancer Prevention and Intervention, National Ministry of Education, Provincial Key Laboratory of Molecular Biology in MedicalSciences), The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 31009, China.|Department of Oncology, Second Affiliated Hospital, ZhejiangUniversity School of Medicine, Hangzhou, 310009, China.
authors: Zhigang
authors: Z
authors: Chen
authors: Cancer Institute (Key Laboratory of Cancer Prevention and Intervention, National Ministry of Education, Provincial Key Laboratory of Molecular Biology in MedicalSciences), The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 31009, China. drhuangjian@zju.edu.cn.|Department of Oncology, Second Affiliated Hospital, ZhejiangUniversity School of Medicine, Hangzhou, 310009, China. drhuangjian@zju.edu.cn.
authors: Jian
authors: J
authors: Huang
mesh_terms: D001943:Breast Neoplasms / Q000276:immunology* / Q000401:mortality / Q000473:pathology; D005260:Female; D051858:Forkhead Transcription Factors; D006801:Humans; D016246:Lymphocytes, Tumor-Infiltrating / Q000276:immunology*; D016019:Survival Analysis; D050378:T-Lymphocytes, Regulatory / Q000276:immunology*
chemical_list: C418974:FOXP3 protein, human; D051858:Forkhead Transcription Factors
keywords: Breast cancer; FOXP3; Prognosis; TIL