Evidence map›Paper›PMID 42071196›Full record

SynthesisBMC cancer2026

Prognostic value of tumor-infiltrating lymphocytes and common subtypes in patients with gastroenteropancreatic neuroendocrine neoplasms: a systematic review and meta-analysis.

Qiming Zheng, Xinyue Xie, Qingjun Guo, Chiyi Chen, Wentao Jiang

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Qiming ZhengDepartment of Liver Transplantation, First Central Hospital of Tianjin Medical University, No. 24 Fukan Road, Nankai District, Tianjin, 300192, China.
Xinyue XieDepartment of Liver Transplantation, First Central Hospital of Tianjin Medical University, No. 24 Fukan Road, Nankai District, Tianjin, 300192, China.
Qingjun GuoDepartment of Liver Transplantation, Tianjin First Central Hospital, Tianjin, 300192, China.
Chiyi ChenDepartment of Liver Transplantation, First Central Hospital of Tianjin Medical University, No. 24 Fukan Road, Nankai District, Tianjin, 300192, China. ccy_616@126.com.
Wentao JiangDepartment of Liver Transplantation, First Central Hospital of Tianjin Medical University, No. 24 Fukan Road, Nankai District, Tianjin, 300192, China. jiangwentao@nankai.edu.cn.

Funding

the Independent Research Fund of the Institute of Transplant Medicine at Nankai University No. NKTM2023004the Key Project of Tianjin Science and Technology Bureau Applied Basic Research No. 23JCZDJC01200the Tianjin Key Medical Discipline Construction Project No. TJYXZDXK-3-006A-1
6 · The paper itself

Abstract

backgroundThe incidence of gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) has been rising. However, current prognostic evaluation systems have certain limitations. As a key component of the tumor microenvironment, the prognostic value of tumor-infiltrating lymphocytes (TILs) in GEP-NENs remains controversial. This study aims to systematically evaluate the prognostic impact of common TILs subsets, including CD3+, CD4+, CD8+, and FoxP3 + cells, in patients with GEP-NENs to provide evidence-based support.

methodsFollowing the PRISMA guidelines, we systematically searched PubMed, EMBASE, the Cochrane Library, and Web of Science for studies published up to February 2026. Two researchers independently completed the literature screening, data extraction, and quality assessment using the Newcastle-Ottawa Scale (NOS). Meta-analysis was performed using Stata 17.0 software to calculate pooled hazard ratios (HR) with 95% confidence intervals (CI). Heterogeneity testing, subgroup analysis, sensitivity analysis, and GRADE certainty of evidence assessment were also conducted.

resultsA total of 8 studies involving 915 patients were included after corrected literature screening. The meta-analysis demonstrated that a high density of FoxP3+ TILs was significantly associated with worse overall survival (OS) in patients with GEP-NENs (HR = 2.18, 95% CI: 1.36-3.49, P = 0.001). In contrast, infiltration of CD3+, CD4+, and CD8+ TILs showed no significant correlation with OS. The analysis of total TILs was not meta-analyzed as only one study reported this data; qualitatively, it showed a significant association with OS (HR = 1.37, 95% CI: 1.13-1.65). Exploratory subgroup analyses indicated that the prognostic value might be influenced by tumor location and the site of TILs detection. Sensitivity analysis confirmed the stability of the results, and publication bias could not be reliably assessed due to the small number of studies. GRADE assessment showed low-to-moderate certainty of evidence for all pooled estimates.

conclusionHigh infiltration of FoxP3+ TILs can serve as a potential prognostic biomarker for poor prognosis in patients with GEP-NENs. The prognostic value of CD3+, CD4+, and CD8+ TILs remains unclear. The evaluation of TILs subsets is influenced by tumor characteristics and may help guide prognostic stratification and immunotherapeutic strategies. However, further validation through multicenter prospective studies and standardized protocols is needed.

Indexed as

Intestinal NeoplasmsLymphocytes, Tumor-InfiltratingNeuroendocrine TumorsPancreatic NeoplasmsStomach NeoplasmsHumansPrognosisTumor MicroenvironmentBiomarkerGastroenteropancreatic neuroendocrine neoplasmsMeta-analysisPrognosisTumor-infiltrating lymphocytes

Identifiers

PMID42071196
PMCPMC13321484

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.