Department of Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.
Department of Gynecology and Obstetrics, The First Affiliated Hospital of Anhui Medical University, Hefei, China.
Am J Med Sci. 2020 Jun;359(6):339-346. doi: 10.1016/j.amjms.2020.03.020. Epub 2020 Apr 5.
There is a growing interest in using programmed death ligand-1 (PD-L1) as a prognostic marker for melanoma. We conducted this meta-analysis to explore the prognostic and clinicopathological value of PD-L1 in melanoma.
The electronic databases PubMed, Web of Science and the Cochrane Library were searched for relevant studies. The major investigated parameters were PD-L1 expression levels in relation to patient gender, tumor-infiltrating lymphocytes (TILs), tumor stage, lymph node (LN) metastasis, histological type, progression-free survival (PFS) and overall survival (OS). Odds ratios (ORs) and hazard ratios (HRs) were computed using the fixed-effect or random-effects model according to data heterogeneity.
Positive PD-L1 expression was significantly associated with high levels of TILs (OR = 7.56, 95% CI 2.04-28.02), metastatic melanoma (OR = 0.45, 95% CI 0.30-0.67) and LN-positive melanoma (OR = 2.56, 95% CI 1.31-4.99) but not gender or histological type. In addition, the pooled HRs showed no relation between PD-L1 expression and PFS (HR = 1.18, 95% CI 0.83-1.69) or OS (HR = 0.77, 95% CI 0.47-1.25). When restricted to metastatic melanoma, positive PD-L1 expression was significantly related to prolonged OS (HR = 0.57, 95% CI 0.46-0.70).
Positive PD-L1 expression may be an important prognostic factor for longer OS in patients with metastatic melanoma.
程序性死亡配体 1（PD-L1）作为黑色素瘤的预后标志物，受到越来越多的关注。本研究进行了荟萃分析，旨在探讨 PD-L1 在黑色素瘤中的预后和临床病理价值。
通过电子数据库 PubMed、Web of Science 和 Cochrane Library 检索相关研究。主要研究参数为 PD-L1 表达水平与患者性别、肿瘤浸润淋巴细胞（TILs）、肿瘤分期、淋巴结（LN）转移、组织学类型、无进展生存期（PFS）和总生存期（OS）的关系。根据数据异质性，采用固定效应或随机效应模型计算比值比（OR）和风险比（HR）。
PD-L1 阳性表达与高水平 TILs（OR=7.56，95%CI 2.04-28.02）、转移性黑色素瘤（OR=0.45，95%CI 0.30-0.67）和 LN 阳性黑色素瘤（OR=2.56，95%CI 1.31-4.99）显著相关，但与性别或组织学类型无关。此外，合并 HR 显示 PD-L1 表达与 PFS（HR=1.18，95%CI 0.83-1.69）或 OS（HR=0.77，95%CI 0.47-1.25）之间无相关性。当仅限于转移性黑色素瘤时，PD-L1 阳性表达与 OS 延长显著相关（HR=0.57，95%CI 0.46-0.70）。
PD-L1 阳性表达可能是转移性黑色素瘤患者 OS 延长的重要预后因素。
