PD-L1表达与胃癌预后及临床病理特征相关性Meta分析

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％CI: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＞5 cm的胃癌患者中更常见.

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

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 RevMan5.3 software,Newcastle-Ottava 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 1 322 patients) were included in the meta-analysis.The Meta-analysis results suggested that PD-L1 positive expression was associated with worse OS at both 3 years (OR=2.88,95％CI:2.19-3.79,P＜0.001) and 5 years (OR=2.95,95％CI:1.70-5.10,P＜0.001) in GC.Moreover,higher PD-L1 expression was related with positive lymph node metastasis (OR=3.32,95 ％CI:2.35-4.68,P＜0.001) 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％CI: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.