程序性死亡配体1与肺癌患者临床病理特征及预后关系的Meta分析

目的评价程序性死亡配体1(PD-L1)与肺癌患者临床病理特征及预后的关系。方法计算机检索PubMed、Web of Science,the Cochrane Library、中国生物医学文献数据库(CBM)、中国知网(CNKI)、万方数据知识服务平台及维普网等数据库,检索时间自数据库建立至2019年6月,筛选有关PD-L1与肺癌患者临床病理特征及预后关系的对照研究。采用RevMan 5.3统计学软件进行Meta分析,比较肺癌组织/细胞与正常组织/细胞中PD-L1阳性率,有无淋巴结转移及不同病理类型、不同TNM分期患者肺癌组织/细胞PD-L1阳性率,并比较PD-L1阳性/阴性患者生存率。结果最终纳入9篇文献,包含1863例患者。Meta分析结果显示,肺癌组织/细胞PD-L1阳性率高于正常组织/细胞[OR=13.91,95%CI(3.62,53.38)],有淋巴结转移的患者肺癌组织/细胞PD-L1阳性率高于无淋巴结转移的患者[OR=2.73,95%CI(1.59,4.66)],鳞癌患者肺癌组织/细胞中PD-L1阳性率高于腺癌患者[OR=0.70,95%CI(0.50,0.98)],TNM分期Ⅲ+Ⅳ期患者肺癌组织/细胞PD-L1阳性率高于TNM分期Ⅰ+Ⅱ期患者[OR=2.24,95%CI(1.79,2.81)](P<0.05);PD-L1阳性、阴性患者生存率比较,差异无统计学意义[HR=0.74,95%CI(0.39,1.42),P=0.37]。Egger’s检验结果显示,报道PD-L1阳性、阴性患者生存率的文献无发表偏倚。结论现有文献证据表明,PD-L1与肺癌患者淋巴结转移、病理类型、TNM分期关系密切,但其与肺癌患者预后无明显相关性。

Relations of PD-L1 to Clinicopathologic Feature and Prognosis in Patients with Lung Cancer:a Meta-analysis

Objective To evaluate the relations of PD-L1 to clinicopathologic feature and prognosis in patients with lung cancer.Methods Computer was used to search databases(such as PubMed,Web of Science,the Cochrane Library,CMB,CNKI,Wanfang Data and VIP)to screen control studies about relations of PD-L1 to clinicopathologic feature and prognosis in patients with lung cancer from the construction of database to June 2019.RevMan 5.3 statistics software was used to complete this Meta-analysis,positive rate of PD-L1 was compared between lung cancer tissues/cells and normal tissues/cells,meanwhile positive rate of PD-L1 in lung cancer tissues/cells was compared in patients with lymphatic metastasis or not,with different pathological types and TNM stages,moreover survival rate was compared between patients with positive and negative expression of PD-L1.Results A total of 9 literatures were enrolled eventually,including 1,863 cases.Meta-analysis results showed that,positive rate of PD-L1 in lung cancer tissues/cells was statistically significantly higher than that in normal tissues/cells[OR=13.91,95%CI(3.62,53.38)],positive rate of PD-L1 in lung cancer tissues/cells in patients with lymphatic metastasis was statistically significantly higher than that in patients without lymphatic metastasis[OR=2.73,95%CI(1.59,4.66)],positive rate of PD-L1 in lung cancer tissues/cells in patients with squamous carcinoma was statistically significantly higher than that in patients with adenocarcinoma[OR=0.70,95%CI(0.50,0.98)],positive rate of PD-L1 in lung cancer tissues/cells in patients withⅢ-andⅣ-TNM stage was statistically significantly higher than that in patients withⅠ-andⅡ-TNM stage[OR=2.24,95%CI(1.79,2.81)](P<0.05);there was no statistically significant difference in survival rate between patients with positive and negative expression of PD-L1[HR=0.74,95%CI(0.39,1.42),P=0.37].Egger’s test results showed that,there was no publication bias in literatures reported suvival rate betwen patients with positive and negative expression of PD-L1.Conclusion Available literature evidence suggests that,PD-L1 is closely related to lymphatic metastasis,pathological types and TNM stage in patients with lung cancer,but it is not significantly related to the prognosis.