Yang Lianzhou, Xue Rujun, Pan Chunhua
Radiotherapy Department, Central Hospital of Guangdong Nongken, Zhanjiang, Guangdong, People's Republic of China.
Institute of Dermatology, Guangzhou Medical University, Guangzhou, People's Republic of China.
Onco Targets Ther. 2019 May 14;12:3671-3682. doi: 10.2147/OTT.S190168. eCollection 2019.
The prognostic role of programmed death-ligand 1 (PD-L1) in colorectal cancer remains unclear. We employed a meta-analysis to explore the prognostic value of PD-L1 and to ascertain the relationship between PD-L1 expression and clinicopathological characteristics in CRC patients. We systematically searched PubMed, Embase and the Cochrane Library until October 2018. Eligible studies about colorectal cancer that pay attention to PD-L1 expression and studies reporting survival information were included. In order to evaluate the prognostic role of PD-L1 for overall survival (OS) and recurrence-free survival (RFS)/disease-free survival (DFS), Hazard ratio (HR) with 95% confidence interval (CI) was used. Odds ratio (OR) with 95% CI was selected to appraise the correlation between PD-L1 with clinicopathological characteristics of colorectal cancer patients. Begg's funnel plot was used to assess publication bias. Twelve studies involving 4344 patients published from 2013 to 2018 were included in this meta-analysis. Pooled results revealed that PD-L1 overexpression was relevant to shorter OS (HR 1.47, 95% CI =1.01-2.15, =0.04) and shorter RFS/DFS (HR 1.47, 95% CI =1.01-2.15, =0.04). Moreover, Patients with high expression of PD-L1 associated with inferior tumor stage (OR=0.57, 95% CI: 0.45, 0.74, <0.0001) and Vascular invasion-negativity (OR=0.75, 95% CI: 0.6, 0.94, =0.01). But the expression of PD-L1 is not related to age, sex, tumor location, tumor differentiation, pT stage, pN stage, MSI/MMR status. This meta-analysis revealed that PD-L1 can serve as a significant biomarker for negative prognosis and the adverse clinicopathological features of colorectal cancer and could facilitate the better management of individual patients.
程序性死亡配体1(PD-L1)在结直肠癌中的预后作用仍不清楚。我们进行了一项荟萃分析,以探讨PD-L1的预后价值,并确定CRC患者中PD-L1表达与临床病理特征之间的关系。我们系统检索了截至2018年10月的PubMed、Embase和Cochrane图书馆。纳入关注PD-L1表达的结直肠癌相关研究以及报告生存信息的研究。为了评估PD-L1对总生存期(OS)和无复发生存期(RFS)/无病生存期(DFS)的预后作用,使用了具有95%置信区间(CI)的风险比(HR)。选择具有95%CI的比值比(OR)来评估PD-L1与结直肠癌患者临床病理特征之间的相关性。使用Begg漏斗图评估发表偏倚。本荟萃分析纳入了2013年至2018年发表的12项研究,涉及4344例患者。汇总结果显示,PD-L1过表达与较短的OS(HR 1.47,95%CI =1.01-2.15,P =0.04)和较短的RFS/DFS(HR 1.47,95%CI =1.01-2.15,P =0.04)相关。此外,PD-L1高表达的患者与较低的肿瘤分期(OR=0.57,95%CI:0.45,0.74,P<0.0001)和无血管侵犯(OR=0.75,95%CI:0.6,0.94,P =0.01)相关。但PD-L1的表达与年龄、性别、肿瘤位置、肿瘤分化、pT分期、pN分期、微卫星不稳定性/错配修复状态无关。这项荟萃分析表明,PD-L1可作为结直肠癌不良预后和不良临床病理特征的重要生物标志物,并有助于更好地管理个体患者。