Journal of Cancer Research and Clinical Oncology

, Volume 145, Issue 12, pp 3005–3019 | Cite as

Prognostic value and clinicopathological roles of phenotypes of tumour-associated macrophages in colorectal cancer

  • Yamei Zhao
  • Xiaoxu Ge
  • Xiaoming Xu
  • Shaojun Yu
  • Jian WangEmail author
  • Lifeng SunEmail author
Review – Clinical Oncology



The role of tumour-associated macrophages (TAMs) in predicting the prognosis of colorectal cancer (CRC) remains controversial. This is especially so because the prognostic significance and clinicopathological relevance of different subtypes of TAMs in the immune microenvironment of CRC have not yet been established.


To assess the clinicopathological and prognostic value of pan-macrophages, M1-macrophages or M2-macrophages in patients with CRC.


Comprehensive searched on the Medline/PubMed, Web of Science (WoS) and Google Scholar databases was conducted to identify relevant studies published up to April 2019. The association between overall survival (OS), cancer-specific survival (CSS) or disease-free survival (DFS) and TAMs was analysed by meta-analysis.


A total of 3749 patients from 17 studies were included. The pooled hazard ratios (HRs) indicated that high-density pan-macrophages improved OS (HR 0.67, P = 0.02). The pooled HR for M2-macrophages showed that high M2-macrophages infiltration was significantly associated with shorter OS (HR 2.93, P < 0.0001) and DFS (HR 2.04, P = 0.02). The pooled odds ratios (ORs) revealed that high-density TAMs was associated with high CD8+ T cell infiltration (OR 2.04, P = 0.007), no distant metastasis (NDM) (OR 0.38, P < 0.0001), microsatellite instability-high (MSI-H) (OR 0.38, P = 0.001), no lymph node metastasis (NLNM) (OR 0.54, P = 0.0002) and non-mucinous cancer (OR 0.39, P < 0.00001).


Unlike other solid tumours, high-density CD68+ macrophage infiltration can be a good prognostic marker for CRC. However, when macrophages act as targets of combination therapy in CRC treatment, this might be more effective for CRC patients with high CD8+ T cell infiltrate, NDM, MSI-H, NLNM and non-mucinous cancer.


Colorectal cancer Prognostic biomarkers Tumour-associated macrophages Clinicopathological Meta-analysis 



Our special acknowledgments to Mr. Xiang Zhou for helping us with editing.


The study was funded by National Natural Science Foundation of China (No. 81472819, No. 81672342), the Zhejiang Provincial Natural Science Foundation of China (No. LY19H030012), the Fundamental Research Funds for the Central Universities (No. 2019QNA7028, No. 2019FZJD009).

Compliance with ethical standards

Conflict of interest

No potential conflicts of interest were disclosed.

Supplementary material

432_2019_3041_MOESM1_ESM.xlsx (11 kb)
Supplementary material 1 (XLSX 11 kb)


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© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Colorectal Surgery, The Second Affiliated HospitalZhejiang University School of MedicineHangzhouPeople’s Republic of China
  2. 2.Department of Cancer Institute, The Second Affiliated HospitalZhejiang University School of MedicineHangzhouPeople’s Republic of China
  3. 3.Department of Pathology, The Second Affiliated HospitalZhejiang University School of MedicineHangzhouPeople’s Republic of China

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