PD-L1表达与食管癌患者临床特征及预后关系的Meta分析  

The relationship between PD-L1 expression and clinicopathological features and prognosis in esophageal cancer patients: a Meta-analysis

作　　者：谷俊杰[1] 邵亚娟[1] 孙昭[1] 赵林[1] 白春梅[1] GU Junjie;SHAO Yajuan;SUN Zhao;ZHAO Lin;BAI Chunmei(Department of Oncology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医学院北京协和医院肿瘤内科,北京100730

出　　处：《癌症进展》2019年第6期655-660,735,共7页Oncology Progress

摘　　要：目的应用Meta分析方法探讨程序性死亡受体配体1(PDCD1LG1,PD-L1)在食管癌中的表达及其临床意义。方法指定文献纳入和排除标准,设计检索策略,通过PubMed、EMBASE、Medline和Cochrane临床对照试验中心注册数据库(CENTRAL)检索关于PD-L1表达与食管癌患者临床特征和总生存情况关系的随机对照研究、病例对照研究和队列研究,筛选文献,提取数据,纳入研究的方法学质量采用纽卡斯尔-渥太华量表(NOS)进行评价。结果共纳入12项研究(包括2122例食管癌患者),汇总分析结果显示,PD-L1表达与食管癌患者的不良预后可能有关(P﹤0.01),死亡风险增加45%。对11项研究(包括2021例食管鳞状细胞癌患者)进行亚组分析,结果显示,PD-L1表达与食管鳞状细胞癌患者的不良预后可能有关(P﹤0.01),死亡风险增加39%。远处转移、晚期(Ⅳ期)与食管癌患者食管癌组织中PD-L1的表达均有关(P﹤0.05),与食管癌位置为中上段可能有关(P=0.05),但与患者的性别、分化程度、浸润深度和淋巴结转移情况均无关(P﹥0.05)。结论 PD-L1可能是食管癌患者预后的重要预测指标,且有助于临床医师更好地筛查程序性死亡因子通路阻滞剂的潜在受益人群。Objective The expression of programmed cell death 1 ligand 1 (PD-L1) in esophageal cancer (EC) and its clinical significance were investigated by Meta- analysis. Method By setting up inclusion and exclusion criteria, search strategies were established for the PubMed, EMBASE, Medline and the ochrane central register of controlled trials (CENTRAL) to retrieve randomized controlled trials, case-control study, and cohort studies that investigated the relationship between pathological features and overall survival (OS) in PD-L1 positive and PD-L1 negative patients with EC. Methodological quality was assessed with the Newcastle-Ottawa scale (NOS). Result A total of 2122 patients in 12 studies were included in this Meta-analysis. Summary analysis results indicated that PD-L1 expression was possibly associated with a shorter OS (P<0.01), increased risk of death by 45%. In subgroup analysis, 11 studies consisting of 2021 esophageal squamous cell carcinoma patients were included in the Meta-analysis, and the results showed that the expression of PD-L1 was likely associated with poor OS in esophageal squamous cell carcinoma patients (P<0.01), increased risk of death by 39%. Distal metastasis and advanced stage (stage IV) were associated with the expression of PD-L1 (P<0.05), and upper and middle esophageal cancer was probably associated with the expression of PD-L1 (P=0.05). However, the expression of PD-L1 was independent of gender, degree of differentiation, depth of invasion, and lymph node metastasis (P>0.05). Conclusion This Meta-analysis indicates that the expression of PD-L1 is a valuable predictor for the prognosis of esophageal cancer patients, and it may be helpful for clinicians to better screen candidates who might benefit from PD pathway blockade.

关 键 词：食管癌 程序性死亡受体配体1 META分析 预后 通路阻滞剂 

分 类 号：R735.1[医药卫生—肿瘤]