title: The Prognostic and Clinicopathological Significance of Tumor-Associated Macrophages in Patients with Gastric Cancer: A Meta-Analysis.
abstract: OBJECTIVE
  Comprehensive studies have investigated the prognostic and clinicopathological value of tumor-associated macrophages (TAMs) in gastric cancer patients, yet results remain controversial. Therefore, we performed a meta-analysis to clarify this issue.
  
  
  METHODS
  PubMed, Embase, and the Cochrane Library databases were searched to identify eligible studies. We extracted hazard ratios (HRs) and odds ratios (ORs) with their corresponding 95% confidence intervals (95% CIs) to estimate the effect sizes. In addition, subgroup analysis and sensitivity analysis were also conducted.
  
  
  RESULTS
  A total of 19 studies involving 2242 patients were included. High generalised TAMs density was significantly associated with poor overall survival (OS) (HR 1.49, 95% CI 1.15-1.95). Subgroup analysis revealed that CD68+ TAMs had no significant effect on OS (HR 1.38, 95% CI 1.00-1.91). High M1 TAMs density was correlated with better OS (HR 0.45, 95% CI 0.32-0.65). By contrast, high density of M2 TAMs was correlated with a poor prognosis for OS (HR 1.48, 95% CI 1.25-1.75). Furthermore, high M2 TAMs density was correlated with larger tumor size, diffuse Lauren type, poor histologic differentiation, deeper tumor invasion, lymph node metastasis, and advanced TNM stage.
  
  
  CONCLUSIONS
  Overall, this meta-analysis reveal that although CD68+ TAMs infiltration has the neutral prognostic effects on OS, the M1/M2 polarization of TAMs are predicative factor of prognosis in gastric cancer patients.
authors.affiliation: Department of Surgical Oncology, The First Hospital of China Medical University, Shenyang, Liaoning, China.
authors.forename: Songcheng
authors.initials: S
authors.lastname: Yin
authors.affiliation: Department of Surgical Oncology, The First Hospital of China Medical University, Shenyang, Liaoning, China.
authors.forename: Jinyu
authors.initials: J
authors.lastname: Huang
authors.affiliation: Department of Breast Surgery, The First Hospital of China Medical University, Shenyang, Liaoning, China.
authors.forename: Zhan
authors.initials: Z
authors.lastname: Li
authors.affiliation: Department of Surgical Oncology, The First Hospital of China Medical University, Shenyang, Liaoning, China.
authors.forename: Junyan
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Surgical Oncology, The First Hospital of China Medical University, Shenyang, Liaoning, China.
authors.forename: Jiazi
authors.initials: J
authors.lastname: Luo
authors.affiliation: Department of Surgical Oncology, The First Hospital of China Medical University, Shenyang, Liaoning, China.
authors.forename: Chunyang
authors.initials: C
authors.lastname: Lu
authors.affiliation: Department of Surgical Oncology, The First Hospital of China Medical University, Shenyang, Liaoning, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Xu
authors.affiliation: Department of Surgical Oncology, The First Hospital of China Medical University, Shenyang, Liaoning, China.
authors.forename: Huimian
authors.initials: H
authors.lastname: Xu
mesh_terms: D015703:Antigens, CD / Q000378:metabolism; D015214:Antigens, Differentiation, Myelomonocytic / Q000378:metabolism; D016208:Databases, Factual; D006801:Humans; D008207:Lymphatic Metastasis; D008264:Macrophages / Q000276:immunology / Q000473:pathology*; D009367:Neoplasm Staging; D016017:Odds Ratio; D011379:Prognosis; D016016:Proportional Hazards Models; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D016019:Survival Analysis; D000097382:CD68 Molecule
chemical_list: D015703:Antigens, CD; D015214:Antigens, Differentiation, Myelomonocytic; C067980:CD68 antigen, human; D000097382:CD68 Molecule