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程序性细胞死亡配体 1(PD-L1)在肝细胞癌中的预后价值:一项荟萃分析。

Prognostic value of programmed cell death ligand 1 (PD-L1) for hepatocellular carcinoma: a meta-analysis.

机构信息

Department of Hepatobiliary-Pancreatic Surgery, China-Japan Union Hospital of Jilin University, Changchun 130000, Jilin, China.

Department of Neurosurgery, China-Japan Union Hospital of Jilin University, Changchun, China.

出版信息

Biosci Rep. 2020 Apr 30;40(4). doi: 10.1042/BSR20200459.

Abstract

The prognostic role of programmed death ligand-1 (PD-L1) expression in hepatocellular carcinoma (HCC) has been widely studied but the results are controversial. In this comprehensive meta-analysis, we elucidated the clinical value of PD-L1 in HCC. Relevant studies were systematically searched in the Cochrane Library, EMBASE, and PubMed until June 27, 2019. Eligible studies were validated for the prognostic effect of PD-L1 on the overall survival (OS), disease-free survival (DFS), and relapse-free survival (RFS) in HCC using a hazard ratio (HR) and its 95% confidence interval (95% CI). Twenty-three studies with 3529 patients were involved in this meta-analysis. The pooled results revealed that high membrane-bound PD-L1 (mPD-L1) expression was associated with poor OS (HR: 1.42; 95% CI: 1.12-1.80; P = 0.004) and had no significant correlation with RFS (HR: 1.14; 95% CI: 0.85-1.54; P = 0.39), and DFS (HR: 1.36; 95% CI: 0.81-2.28; P = 0.25). The results also indicated that high soluble PD-L1 (sPD-L1) levels were associated with worse OS (HR: 2.93; 95% CI: 2.20-3.91; P < 0.00001). In addition, high mPD-L1 expression was associated with high alpha-fetoprotein levels (AFP; OR = 1.46; 95% CI: 1.16-1.84; P = 0.001), hepatitis (OR = 0.72; 95% CI: 0.54-0.98; P = 0.03), poor tumor differentiation (OR = 0.68; 95% CI: 0.55-0.84; P = 0.03), and tumor-infiltrating lymphocytes (OR = 3.39; 95% CI: 1.06-10.91; P = 0.04). The mPD-L1 expression had no significant correlation with age, number of tumors, gender, tumor size, liver cirrhosis, vascular invasion, tumor encapsulation, or TNM stage. The study revealed that high mPD-L1 expression in the tumor tissue and high sPD-L1 levels were associated with shorter OS in HCC. Moreover, overexpression of mPD-L1 was significantly associated with poor tumor differentiation, hepatitis, AFP elevation, and tumor-infiltrating lymphocytes.

摘要

程序性死亡配体 1(PD-L1)在肝细胞癌(HCC)中的表达的预后作用已得到广泛研究,但结果存在争议。在这项综合荟萃分析中,我们阐明了 PD-L1 在 HCC 中的临床价值。系统地检索了 Cochrane 图书馆、EMBASE 和 PubMed 中的相关研究,检索时间截至 2019 年 6 月 27 日。使用风险比(HR)及其 95%置信区间(95%CI),对 PD-L1 对 HCC 患者的总生存期(OS)、无病生存期(DFS)和无复发生存期(RFS)的预后影响进行验证。共有 23 项研究,涉及 3529 例患者,纳入本荟萃分析。汇总结果显示,高膜结合 PD-L1(mPD-L1)表达与较差的 OS 相关(HR:1.42;95%CI:1.12-1.80;P = 0.004),但与 RFS(HR:1.14;95%CI:0.85-1.54;P = 0.39)和 DFS(HR:1.36;95%CI:0.81-2.28;P = 0.25)无显著相关性。结果还表明,高可溶性 PD-L1(sPD-L1)水平与较差的 OS 相关(HR:2.93;95%CI:2.20-3.91;P < 0.00001)。此外,高 mPD-L1 表达与高甲胎蛋白(AFP)水平相关(OR = 1.46;95%CI:1.16-1.84;P = 0.001),乙型肝炎(OR = 0.72;95%CI:0.54-0.98;P = 0.03),肿瘤分化不良(OR = 0.68;95%CI:0.55-0.84;P = 0.03)和肿瘤浸润淋巴细胞(OR = 3.39;95%CI:1.06-10.91;P = 0.04)相关。mPD-L1 表达与年龄、肿瘤数量、性别、肿瘤大小、肝硬化、血管侵犯、肿瘤包膜、TNM 分期无显著相关性。该研究表明,肿瘤组织中高 mPD-L1 表达和高 sPD-L1 水平与 HCC 患者的 OS 较短有关。此外,mPD-L1 的过表达与肿瘤分化不良、乙型肝炎、AFP 升高和肿瘤浸润淋巴细胞显著相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b150/7167253/24b295e0996b/bsr-40-bsr20200459-g1.jpg

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