PD-1/PD-L1在食管鳞状细胞癌中的表达及其与肿瘤预后相关性的系统评价与Meta分析  

Expression of PD-1/PD-L1 in esophageal squamous cell carcinoma and its relationship with survival prognosis: A systematic review and meta-analysis

作　　者：余琦瑶 李斌[1] 冯海明[1] 蔺军平 尹泚 李政 李璇 孙移明 毛文杰 李杰[1] 肖翠 YU Qiyao;LI Bin;FENG Haiming;LIN Junping;YIN Ci;LI Zheng;LI Xuan;SUN Yiming;MAO Wenjie;LI Jie;XIAO Cui(Department of Thoracic Surgery,Lanzhou University Second Hospital,Lanzhou University Second Clinical Medical College,Lanzhou,730030,P.R.China)

机构地区：[1]兰州大学第二医院胸外科兰州大学第二临床医学院,兰州730030

出　　处：《中国胸心血管外科临床杂志》2021年第11期1352-1359,共8页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：甘肃省科技重点研发计划项目(20YF3FA032);兰州市科技计划项目(2018-3-045)。

摘　　要：目的系统评价程序性死亡受体1(PD-1)和程序性死亡配体1(PD-L1)在食管鳞状细胞癌(鳞癌)组织中的表达及其与食管鳞癌预后的关系。方法计算机检索PubMed、EMbase、The Cochrane Library、Web of Science、中国知网以及万方数据库,检索时限为各数据库建库至2020年2月22日。筛选文献、提取资料并评价文献质量,采用RevMan 5.3软件进行Meta分析,采用Egger’s和Begg’s检验评价发表偏倚,采用Stata 15.1软件行敏感性分析。结果共纳入16篇文献,3 378例食管鳞癌患者。非随机对照试验的方法学评价指标(MINORS)评分均为12分及以上。Meta分析结果表明:在肿瘤细胞中,PD-1、PD-L1的阳性表达率分别为37.8%(190/504)和41.7%(1 407/3 378)。PD-L1在肿瘤免疫浸润细胞中的阳性表达率为41.7%(412/987)。肿瘤细胞PD-L1高表达组的总体生存率(OS)低于低表达组[HR=1.30,95%CI(1.01,1.69),P=0.04]。肿瘤免疫浸润细胞PD-L1高表达组的OS明显高于低表达组[HR=0.65,95%CI(0.53,0.80),P<0.000 1]。结论肿瘤细胞和肿瘤免疫浸润细胞PD-L1在食管鳞癌中具有较高的表达率,是食管鳞癌生存预后的重要因素。Objective To systematically evaluate the expression of programmed cell death receptor 1(PD-1) and programmed cell death ligand 1(PD-L1) in esophageal squamous cell carcinoma and its relationship with prognosis.Methods The literature from PubMed, EMbase, The Cochrane Library, Web of Science, CNKI and Wanfang data from inception to February 22, 2020 was searched by computer. Data were extracted and the quality of literature was evaluated using RevMan 5.3 software for meta-analysis. Egger’s and Begg’s tests were used to evaluate publication bias, and Stata 15.1 software was used for sensitivity analysis. Results A total of 16 articles were included, and there were 3 378 patients with esophageal squamous cell carcinoma. The methodological index for nonrandomized studies(MINORS) scores were all 12 points and above. The meta-analysis results showed that the positive expression rates of PD-1 and PD-L1 in tumor cells were 37.8%(190/504) and 41.7%(1 407/3 378), respectively. The positive expression of PD-L1 in tumor immune infiltrating cells was 41.7%(412/987). The overall survival(OS) of the tumor cell with high PD-L1 expression was lower than that with low PD-LI expression(HR=1.30, 95%CI 1.01-1.69, P=0.04). The OS of the tumor immune infiltrating cell with high PD-L1 expression was significantly higher than that with low PD-LI expression(HR=0.65, 95%CI 0.53-0.80,P<0.000 1). Conclusion PD-L1 has a high expression rate in esophageal squamous cell carcinoma and is an important factor for the prognosis of esophageal squamous cell carcinoma.

关 键 词：食管鳞状细胞癌 程序性死亡受体1(PD-1) 程序性死亡配体1(PD-L1) 预后 系统评价/META分析 

分 类 号：R735.1[医药卫生—肿瘤]