PD-L1表达与胃癌预后及临床病理特征相关性Meta分析  

Correlation of PD-L1 expression with prognosis and clinicopathological features in gastric carcinoma:A meta-analysis

作　　者：丁琦[1] 孙国平[1] DING Qi SUN Guo-ping(Department of Oncology ,First Affiliated Hospital of Anhui Medical University, Hefei 230022 ,P. R. Chin)

机构地区：[1]安徽医科大学第一附属医院肿瘤内科,安徽合肥230022

出　　处：《中华肿瘤防治杂志》2016年第24期1638-1644,共7页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的程序性死亡受体-配体1（programmed cell death-Ligand 1,PD-L1）在恶性肿瘤的免疫逃逸中起到重要作用。本研究采用Meta分析评价方法,探讨PD-L1表达与胃癌预后及临床病理特征的相关性。方法检索Medline/PubMed、EMBASE、Cochrane Library、Springer、万方、维普和中国知网等数据库,收集2016-05-25前公开发表的关于PD-L1表达与胃癌预后相关性的回顾性队列研究。采用RevMan5.3软件进行Meta分析,Newcastle-OttawaScale（NOS）量表进行文献质量评价,漏斗图评估文献的发表偏移。采用比值比（odds ratio,OR）及95%可信区间（confidence interval,CI）评价关联强度。结果共纳入8篇文献（1 322例患者）进行Meta分析。结果显示,PD-L1阳性表达与胃癌患者3年总体生存率（OR=2.88,95%CI：2.19～3.79,P〈0.001）及5年总体生存率（OR=2.95,95%CI：1.70～5.10,P〈0.001）降低有关。PD-L1表达差异与淋巴结转移（OR=3.32,95%CI：2.35～4.68,P〈0.001）、肿瘤大小（OR=1.52,95%CI：1.12～2.05,P=0.007）有关,而与性别（OR=1.14,95%0.89～1.46,P=0.290）、分化程度（OR=1.02,95%CI：0.68～1.53,P=0.920）、浸润深度（OR=2.14,95%CI：0.93～4.94,P=0.080）、TNM分期（OR=1.99,95%CI：0.77～5.16,P=0.160）无关。结论 PD-L1与胃癌预后有关,其阳性表达在淋巴结转移阳性、肿瘤直径〉5cm的胃癌患者中更常见。OBJECTIVE Programmed cell death-Ligand 1（PD-L1）plays an important role in immune escape of malignancies.This study was designed to investigate the correlation of PD-L1 expression with prognosis and clinicopathological features in gastric carcinoma through a meta-analysis.METHODS Medline/PubMed,EMBASE,the Cochrane Library,Springer,WanFang,CNKI and WeiPU databases were searched for collecting retrospective cohort studies of the association between PD-L1 expression and GC,up to May 25,2016.Meta analysis was carried out by RevMan5.3software,Newcastle-Ottawa Scale（NOS）scale was used for evidence quality assessment,and publication bias was evaluated through the funnel chart.Correlation intensity was evaluated using odds ratio（OR）and 95% confidence interval（CI）.RESULTS Eight studies（involving 1 322patients）were included in the meta-analysis.The Meta-analysis results suggested that PD-L1 positive expression was associated with worse OS at both 3years（OR=2.88,95%CI：2.19-3.79,P0.001）and 5years（OR=2.95,95%CI：1.70-5.10,P0.001）in GC.Moreover,higher PD-L1 expression was related with positive lymph node metastasis（OR=3.32,95%CI：2.35-4.68,P0.001）and greater tumor size（OR=1.52,95%CI：1.12-2.05,P=0.007）.There was no significant correlation with gender（OR=1.14,95% 0.89-1.46,P=0.290）,tumor differentiation（OR=1.02,95%CI：0.68-1.53,P=0.920）,depth of tumor（OR=2.14,95%CI：0.93-4.94,P=0.080）and TNM stage（OR=1.99,95%CI：0.77-5.16,P=0.160）.CONCLUSION The meta-analysis suggests that PD-L1 positive expression is associated with worse survival in GC,and is more common in patients with positive lymph node metastasis and bigger tumor size.

关 键 词：程序性死亡受体-配体1 胃肿瘤 预后 生存率 META分析 

分 类 号：R735.2[医药卫生—肿瘤]