Table 1. Characteristics of included studies.
Study, Year | Biomarker | Location | Outcome | HR | Covariates in adjustment model | n of Patients | Male (%) | Stage (%) | Histology (%) | Smoking Status | Cutoff Value |
---|---|---|---|---|---|---|---|---|---|---|---|
Takanami, 2000 [25] | MCs | Tumor | OS | Adj |
gender, T, N, differentiation, microvascular density |
180 | 56 | I: 55 | ADC: 100 | NR | MCD>21 |
II: 14 | |||||||||||
III: 31 | |||||||||||
Pelletier, 2001 [26] | CD20 | Peritumor | OS | Adj |
stage, histology, gender |
113 | 60 | I: 58 | ADC: 50 | Current: 92% | >10% |
II: 18 | SCC: 42 | ||||||||||
III: 24 | LCC: 3 | ||||||||||
Other: 5 | |||||||||||
Kojima, 2002 [27] | CD68 MCs | Intratumor | OS | Unadj and Adj |
VEGF, microvessel density |
132 | 67 | I: 100 | ADC: 71 | NR | Mean |
SCC: 29 | |||||||||||
Villegas, 2002 [28] | CD57 | Intratumor | OS | Unadj and Adj |
stage, age, endoscopy localization |
50 | 98 | I: 82 | SCC: 100 | Current: 74% | Median |
II: 12 | Former: 22% | ||||||||||
III: 6 | Never: 4% | ||||||||||
Pelosi, 2004 [29] | MCs | Tumor | OS & DFS | Unadj and Adj |
age, diameter, pT, Ki-67 labelling index, HER-2, tumor grade, symptoms, blc-2, synaptophysin |
201 | 91 | I: 100 | ADC: 44 | NR | ≥5% |
SCC: 56 | |||||||||||
Kojima, 2005 [30] | CD68 MCs | Tumor | Unadj and Adj (adenocarcinoma only) |
tumor VEGF, tumor VEGF-C, tumor VEGFR-3, microvessel density |
129 | 48 | I: 100 | ADC: 100 | Smoker: 40% | Staining score >3 | |
Non-smoker: 60% | |||||||||||
Petersen, 2006 [31] | CD3 | Tumor | DFS | Unadj | n/a | 64 | 53 | I: 100 | ADC: 46 | Mean pack-year 51 ± 33 | Score ≥2 (median) |
SCC: 34 | |||||||||||
Other: 19 | |||||||||||
Kikuchi, 2007 [32] | CD8 | Cancer-Nest | OS | Unadj | n/a | 161 | 68 | I: 59* | ADC: 52 | Never: 24% | 1-cell increment |
CD56 | II/III/IV: 41 | SCC: 42 | Ever: 67% | ||||||||
Other: 6 | Unknown: 9% | ||||||||||
Dieu-Nosjean, 2008 [33] | CD3 | Tumor | OS & DFS | Unadj | n/a | 74 | 81 | I: 84 | ADC: 62 | Current: 91% | 1.5 mean score |
CD20 | II: 16 | SCC: 38 | Never: 9% | ||||||||
Shimizu, 2010 [34] | FoxP3 | Intratumor | DFS | Adj |
nodal involvement, COX-2 expression |
100 | 60 | I: 68 | ADC: 69 | NR | ≥3% |
II: 14 | SCC: 31 | ||||||||||
III: 18 | |||||||||||
da Costa Souza, 2012 [35] | CD4 | OS | Adj | stage and histological type | 65 | 69 | I: 31 | ADC: 58 | Pack-years median 41(0–120) | CD4: ≥16.1% | |
CD8 | II: 51 | SCC: 31 | CD8: ≥1.8% | ||||||||
CD68 | III: 18 | LCC: 11 | CD68: ≥4.5% | ||||||||
Hanagiri, 2013 [36] | FoxP3 | Regional Lymph Nodes | OS | Unadj and Adj |
gender, pack-year index, T factor, N factor |
158 | 65 | I: 72 | ADC: 59 | NR | >0.5% PBL |
II: 11 | SCC: 22 | >1.1% RLNL | |||||||||
III: 19 | Other: 9 | ||||||||||
Suzuki, 2013 [37] | FoxP3 | Stroma | DFS | Unadj and Adj |
gender, stage, lymphatic invasion, IL-12R, IL-7R |
956 (478) | 36 | I: 100 | ADC: 100 | Current: 16% | Score ≥2 |
Former: 69% | |||||||||||
Never: 15% | |||||||||||
Feng, 2014 [38] | CD68 | Islet and Stroma | OS & DFS | Adj |
mediastinal down staging, islet/stromal machrophage ratio |
28 | 54 | III: 100 | ADC: 70 | Smoker: 39% | median |
SCC: 21 | Never: 61% | ||||||||||
Germain, 2014 [39] | CD20 | Tumor | OS | Unadj | n/a | 74 | 81 | I: 84 | ADC: 62 | Current: 91% | CD20: 0.0255 mm2/tumor IPF |
II: 16 | SCC: 38 | Never: 9% | |||||||||
Hanagiri, 2014 [40] | FoxP3 | Regional Lymph Nodes | OS | Unadj and Adj |
gender, age, histology |
131 | 57 | I: 100 | ADC: 76 | NR | Relative expression > 0.06 |
SCC: 16 | |||||||||||
Other: 8 | |||||||||||
Lee, 2014 [41] | CD68 | DFS | Adj |
procedure, stage, CD68, FoxP3/CD3 |
151 | 40 | I: 100 | ADC: 77 | Current: 7% | Score ≥2 | |
SCC: 23 | Former: 72% | ||||||||||
Never: 21% | |||||||||||
Djenidi, 2015 [42] | CD3 | Total (tumor + stroma) | OS & DFS | Unadj | n/a | 101 | 68 | I: 100 | ADC: 45 | Ever: 89% | Continuous variables |
CD8 | SCC: 42 | ||||||||||
Other: 13 | |||||||||||
Hernandez-Prieto, 2015 [43] | CD3 | Stroma | DFS | Unadj | n/a | 84 | 86 | I: 71 | ADC: 48 | Current: 43% | Moderate 10% |
CD4 | II: 29 | SCC: 46 | Former: 51% | Strong 20% | |||||||
CD8 | LCC: 2 | Never: 6% | |||||||||
CD20 | Other: 4 | ||||||||||
CD57 | |||||||||||
Kadota, 2015 [44] | CD3 | Tumor | OS | Unadj | n/a | 331 | 60 | I: 57 | SCC: 100 | ≤90 pack-year: 81% | CD3: High ≥50 |
CD4 | II: 28 | >90 pack-year: 19% | CD4: High ≥20 | ||||||||
CD8 | III: 15 | CD8: High ≥50 | |||||||||
CD20 | CD20: High ≥20 | ||||||||||
CD68 | CD68: High ≥50 | ||||||||||
FoxP3 | FoxP3: High ≥20 | ||||||||||
Neutrophil-(CD10) | CD10: High ≥10 | ||||||||||
Kim, 2015 [45] | CD8 | Tumor | OS & DFS | Unadj | n/a | 331 | 96 | I: 40 | SCC: 100 | Smoker: 91% | Median |
II: 36 | Never: 5% | ||||||||||
III: 24 | |||||||||||
Donnem, 2015 [46] | CD8 | Stroma | OS & DFS | Adj |
stage, differentiation, histology, age |
797 | 64 | I: 51 | ADC: 48 | NR | High density >50% |
II: 35 | SCC: 45 | ||||||||||
III: 15 | LCC: 7 | ||||||||||
Li, 2015 [47] | CD68 | OS & DFS | Adj |
TNM, N stage, subcarinal lymph node, n number of nodal stations involved, number of involved nodes |
159 | 69 | I: 23 | ADC: 26 | Smoker: 31% | ||
II: 36 | SCC: 52 | Never: 69% | |||||||||
III: 24 | |||||||||||
O’Callaghan, 2015 [48] | CD3 | TI/S | OS | Unadj and Adj |
tumor size, stage, lymph node stage, WHO overall stage, positive resection margins, TI/S biomarker ratios |
197 (186) | 62 | I: 55 | ADC: 45 | Current & Former: 94% | Median |
CD8 | II: 24 | SCC: 46 | Never: 6% | ||||||||
FoxP3 | III: 21 | LCC: 3 | |||||||||
Other: 6 | |||||||||||
Paulsen, 2015 [49] | CD8 | Tumor | OS | Unadj | n/a | 536 | 68 | I: 48 | ADC: 38 | Current: 33% | score of ≥2 |
II: 36 | SCC: 54 | Former: 64% | |||||||||
III: 16 | Never: 3% | ||||||||||
Tian, 2015 [50] | CD3 | Tumor | OS | Adj |
histology, pT, pN, pTNM stage, CD3, CD8, IL-2 |
129 | 71 | I: 37 | ADC: 37 | Smoker: 37% | H-score 0–4 = low expression |
CD8 | II: 22 | SCC: 47 | Never: 63% | H-score 5–12 = high expression | |||||||
III: 40 | Other: 16 | ||||||||||
Ameratunga, 2016 [51] | CD8 | Stroma | OS & DFS | Unadj and Adj |
age, sex, pneumonectomy status, nodal stage, histology, smoking status, CD8+, FOXP3, PD-L1 |
527 (509) | 69 | NR | ADC: 55 | Heavy: 73% | Score of % of positively stained cells > 3 |
SCC: 34 | Light: 17% | ||||||||||
Other: 11 | Never: 7% | ||||||||||
Unknown: 4% | |||||||||||
Kinoshita, 2016 [52] | CD4 | Tumor | OS & DFS | Unadj and Adj (for CD20 only) |
age, diameter, nodal metastasis, pleural invasion, FoxP3/CD4 |
218 | 65 | I: 71 | ADC: 72 | Ever: 61% | CD4: > 251 cells/mm2 |
CD8 | II: 11 | SCC: 18 | Never: 39% | CD8: > 110 cells/mm2 | |||||||
CD20 | III: 18 | Other: 10 | FoxP3: > 163 cells/mm2 | ||||||||
FoxP3 | |||||||||||
Parra, 2016 [53] | CD57 | Peri and intra tumor | OS (CD57 only) & DFS | Adj |
tumor stage, adjuvant therapy |
254 | 55 | I: 50 | ADC: 57 | Current: 45% | Median |
CD68 | II: 30 | SCC: 43 | Former: 30% | ||||||||
III: 20 | Never: 17% | ||||||||||
Teng, 2016 [54] | CD8 | Tumor | OS & DFS | Unadj and Adj (for CD8 only) |
high risk, FoxP3/CD8+TILS |
126 | 67 | I: 100 | ADC: 45 | NR | CD3: ≥30% |
FoxP3 | SCC: 33 | FoxP3: ≥45/HPF | |||||||||
LCC: 22 | |||||||||||
Uso, 2016 [55] | CD8 | Tumor and Stroma | OS & DFS (CD8 only) | Adj |
Tumoral CD8+ cells, Stromal FOXP3+ cells, FOXP3+ stroma/CD4+ tumor, FOXP3+ stroma/CD8+ tumor |
122 | 85 | I: 59 | ADC: 42 | Current: 48% | CD8: Median |
FoxP3 | II: 21 | SCC: 47 | Former: 38% | FoxP3: >10% | |||||||
III: 20 | Other: 11 | Never: 14% | |||||||||
Yang, 2016 [56] | CD4 | Tumor and Stroma | OS & DFS | Adj |
age, sex, stage, PD-L1 expression, Stromal CD4+ T cell, Stromal regulatory T cell, Epithelial CD8+ T cell |
105 | 85 | I: 100 | SCC: 100 | Smoker: 75% | CD4: ≥5% (tumor) & ≥25% (stroma) |
CD8 | Non Smoker: 25% | CD8: ≥5% (tumor) & ≥50% (stroma) | |||||||||
FoxP3 | FoxP3: ≥20% | ||||||||||
Yazdi, 2016 [57] | CD8 | Stroma | OS | Unadj and Adj |
stage, sex, HLA-E |
197 | 50 | I: 31 | ADC: 100 | NR | mean |
II: 38 | |||||||||||
III: 18 | |||||||||||
Huang, 2017 [58] | CD8 | Tumor | OS & DFS | Adj |
age, sex, differentiation, histology, tumor, node, CD133, OCT-4, CD8, CD56, HLA I, PD-L1 |
172 | 65 | NR | SCC: 42 | Smoker: 55% | Median |
CD56 | Other: 58 | Non-Smoker: 45% | |||||||||
Kinoshita, 2017 [59] | CD4 | Tumor | OS & DFS | Unadj | n/a | 164 | 5 | I: 68 | ADC: 100 | Non-smoker: 100% | CD4: > 585 cells/mm2 |
CD8 | II, III: 32 | CD8: > 900 cells/mm2 | |||||||||
CD20 | CD20: > 1070 cells/mm2 | ||||||||||
FoxP3 | FoxP3: > 81 cells/mm2 | ||||||||||
Koh, 2017 [60] | CD8 [60] | Tumor | DFS | Adj |
age, lymph node metastasis, CD103+ TILs, CD8+ TILs |
378 | 95 | I, II: 79 | SCC: 100 | Smoker: 90% | mean |
III: 21 | Never: 5% | ||||||||||
Sepesi, 2017 [61] | CD3 | Intratumor | OS | Unadj and Adj |
age, histology, thoracotomy, adjuvant therapy, DLCO %, Zubrod score, Lobectomy, PD-L1 tumor H score, PD-L1 tumor % expression, PD-L1 macrophages H score, PD-L1 macrophages % expression, CD3, CD4, CD8, CD45RO, CD57, CD68, FoxP3, PD-1 |
113 | 49 | I: 100 | ADC: 70 | Current and Former: 89% | CD3: ≥ 827.3 |
CD4 | SCC: 30 | Never: 11% | CD4 ≥ 852.1 | ||||||||
CD8 | CD8: ≥ 292.3 | ||||||||||
CD57 | CD57: ≥ 1408 | ||||||||||
CD68 | CD68: ≥ 515 | ||||||||||
FoxP3 | FoxP3: ≥ 460.3 | ||||||||||
Ye, 2017 [62] | CD8 | OS | Unadj and Adj |
gender, age, pathology grade, T, N, clinical stage |
102 | 54 | I: 20 | ADC: 100 | NR | final score>6 | |
II: 59 | |||||||||||
III: 21 | |||||||||||
Barua, 2018 [63] | CD4 | Tumor | OS | Unadj | n/a | 120 | 43 | I: 4 | ADC: 60 | Current & Former: 83% | G-cross signatures |
CD8 | II: 11 | SCC: 29 | Never: 17% | ||||||||
CD68 | III: 85 | Other: 11 | |||||||||
FoxP3 | |||||||||||
Jackute, 2018 [64] | CD68 | Total | OS | Unadj | n/a | 80 | 80 | I: 29 | ADC: 48 | Smoker: 83% | Median |
II: 33 | SCC: 45 | Non-Smoker: 17% | |||||||||
III: 39 | Other: 7 | ||||||||||
Mazzaschi, 2018 [65] | CD3 | OS & DFS | Unadj | n/a | 100 | 4 | I: 35 | ADC: 42 | Current: 37% | Continuous | |
CD8 | II: 41 | SCC: 58 | Former: 52% | ||||||||
III: 24 | Never: 9% | ||||||||||
Su, 2018 [66] | CD8 | Stroma | OS & DFS | Adj |
age, sex, smoking, micropapillary pattern, CEA, PD-1 expression |
223 | 54 | I: 67 | ADC: 100 | Smoker: 30% | ≥25% |
II: 14 | Non-Smoker: 70% | ||||||||||
III: 19 | |||||||||||
Matsubara, 2019 [67] | CD3 | Tumor Margins | OS | Unadj and Adj |
age, stage, lymphatic invasion, PD-L1, PD-L2 |
211 | 83 | I: 54 | SCC: 100 | Smokers ≥30 pack-years: 85% | Median |
CD4 | II: 35 | ||||||||||
CD8 | III: 11 | ||||||||||
Meng, 2019 [68] | CD4^ | Tumor (FoxP3 Stroma) | OS | Adj |
T, N, CD4, CD8, FoxP3, PD-L1 |
197 | 65 | I: 57 | SCC: 43 | Smoker: 58% | CD4: 5% |
CD8* | II: 45 | Non-SCC: 57 | Non-smoker: 42% | CD8: 5% | |||||||
FoxP3* | III: 40 | FoxP3: 20% | |||||||||
Cao, 2019 [69] | CD68 | Tumor | OS & DFS | Unadj and Adj |
T, N |
137 | 56 | I: 34 | ADC: 68 | Former or Current: 48% | Median |
II: 34 | SCC: 32 | Never: 53% | |||||||||
III: 33 |
*HR reported for stage I only. ^HR reported for squamous only.
#ADC = adenocarcinoma, SCC = squamous cell carcinoma, LCC = large cell carcinoma, NR = not reported, n/a = not applicable, OS = overall survival, DFS = disease free survival, Adj = adjusted for covariates, Unadj = not adjusted for covariates.