Dai Cong, Wang Meng, Lu Jun, Dai Zhiming, Lin Shuai, Yang Pengtao, Tian Tian, Liu Xinghan, Min Weili, Dai Zhijun
Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University.
Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University.
Onco Targets Ther. 2017 Jul 21;10:3625-3634. doi: 10.2147/OTT.S138044. eCollection 2017.
PD-L1 has been reported to be expressed in diverse human malignancies. However, the prognostic value of PD-L1 in digestive system cancers remains inconclusive. Therefore, we conducted this meta-analysis to evaluate the prognostic impact of PD-L1 expression in digestive system cancers.
We searched the PubMed, Embase, and the Chinese National Knowledge Infrastructure for publications concerning PD-L1 expression in digestive system cancers. Correlations of PD-L1 expression level with overall survival (OS), disease-free survival (DFS), and recurrence-free survival (RFS) were analyzed.
Finally, 32 studies with 7,308 patients were included. Our results show that PD-L1 expression was significantly associated with poorer OS (hazard ratio [HR] =1.44, 95% confidence interval [CI] =1.18-1.76, <0.001), but not DFS (HR =0.91, 95% CI =0.61-1.37, =0.657) or RFS (HR =1.27, 95% CI =0.75-2.14, =0.368). Moreover, in the subgroup analysis, significant associations between PD-L1 expression and OS were found in Asians (HR =1.50, 95% CI =1.19-1.89, =0.001), gastric cancer (HR =1.43, 95% CI =1.05-1.94, =0.021), and pancreatic carcinoma (HR =2.64, 95% CI =1.78-3.93, <0.001).
These results suggest that the expression of PD-L1 is associated with worse OS in digestive system cancers, especially in gastric cancer and pancreatic cancer. In addition, PD-L1 may act as a new parameter for predicting poor prognosis and a promising target for anticancer therapy in digestive system cancers.
据报道，PD-L1在多种人类恶性肿瘤中均有表达。然而，PD-L1在消化系统癌症中的预后价值仍尚无定论。因此，我们进行了这项荟萃分析，以评估PD-L1表达对消化系统癌症预后的影响。
我们检索了PubMed、Embase和中国知网，查找有关消化系统癌症中PD-L1表达的文献。分析了PD-L1表达水平与总生存期（OS）、无病生存期（DFS）和无复发生存期（RFS）的相关性。
最终纳入了32项研究，共7308例患者。我们的结果显示，PD-L1表达与较差的总生存期显著相关（风险比[HR]=1.44，95%置信区间[CI]=1.18-1.76，P<0.001），但与无病生存期（HR=0.91，95%CI=0.61-1.37，P=0.657）或无复发生存期（HR=1.27，95%CI=0.75-2.14，P=0.368）无关。此外，在亚组分析中，发现PD-L1表达与总生存期之间存在显著关联的人群为亚洲人（HR=1.50，95%CI=1.19-1.89，P=0.001）、胃癌患者（HR=1.43，95%CI=1.05-1.94，P=0.021）和胰腺癌患者（HR=2.64，95%CI=1.78-3.93，P<0.001）。
这些结果表明，PD-L1的表达与消化系统癌症，尤其是胃癌和胰腺癌的较差总生存期相关。此外，PD-L1可能作为预测预后不良的新参数，以及消化系统癌症抗癌治疗的一个有前景的靶点。
