Wang Feng, Yu Tao, Ma Chengbin, Yuan Hongmou, Zhang Haifei, Zhang Zhiyu
Department of Orthopedics, The Fourth Affiliated Hospital of China Medical University, Shenyang, China.
Center for Translational Medicine, The Fourth Affiliated Hospital of China Medical University, Shenyang, China.
Front Oncol. 2020 Jun 2;10:749. doi: 10.3389/fonc.2020.00749. eCollection 2020.
Programmed cell death 1 ligand-1 (PD-L1) is an immune checkpoint molecule that acts to protect cancer cells from immune surveillance and is considered as a prognostic biomarker in several cancers, but the prognostic value of PD-L1 in bone and soft tissue sarcomas remains inconclusive. In the present meta-analysis, the clinicopathological and prognostic value of PD-L1 in sarcomas was evaluated. We performed a systemic and comprehensive meta-analysis by searching the PubMed, Medline, Cochrane Library, EMBASE, and Web of Science databases up to October 31, 2019. Eligible articles were incorporated, and pooled hazard ratios (HRs) and odds ratios (ORs) with their 95% confidence intervals (CIs) were used to estimate the outcomes. Thirty-six articles containing 39 independent studies with 3,680 bone and soft tissue sarcoma patients were included in our meta-analysis. The pooled results showed that PD-L1 overexpression could predict poor overall survival (HR 1.45, 95% CI 1.11-1.90, < 0.01), metastasis-free survival (HR 1.58, 95% CI 1.14-2.19, < 0.01), and event-free survival (HR 2.82, 95% CI 1.69-4.71, < 0.01) in sarcomas. Furthermore, PD-L1 overexpression was correlated with a higher rate of tumor metastasis (OR 2.95, 95% CI 1.32-6.60, < 0.01), a more advanced tumor grade (OR 3.63, 95% CI 2.55-5.16, < 0.01), and more T lymphocyte infiltration (OR 5.55, 95% CI 2.86-10.76, < 0.01). No obvious publication bias was observed, and the sensitivity analysis showed that our results were robust. The results of our meta-analysis indicate that high PD-L1 expression might serve as a valuable and predictive biomarker for adverse clinicopathological features and poor prognosis in patients with sarcoma.
程序性细胞死亡1配体-1（PD-L1）是一种免疫检查点分子，其作用是保护癌细胞免受免疫监视，在多种癌症中被视为一种预后生物标志物，但PD-L1在骨肉瘤和软组织肉瘤中的预后价值仍尚无定论。在本荟萃分析中，评估了PD-L1在肉瘤中的临床病理特征及预后价值。我们通过检索截至2019年10月31日的PubMed、Medline、Cochrane图书馆、EMBASE和科学网数据库，进行了系统全面的荟萃分析。纳入符合条件的文章，并使用合并风险比（HR）和比值比（OR）及其95%置信区间（CI）来评估结果。我们的荟萃分析纳入了36篇文章，包含39项独立研究，涉及3680例骨肉瘤和软组织肉瘤患者。汇总结果显示，PD-L1过表达可预测肉瘤患者较差的总生存期（HR 1.45，95%CI 1.11-1.90，P<0.01）、无转移生存期（HR 1.58，95%CI 1.14-2.19，P<0.01）和无事件生存期（HR 2.82，95%CI 1.69-4.71，P<0.01）。此外，PD-L1过表达与更高的肿瘤转移率（OR 2.95，95%CI 1.32-6.60，P<0.01）、更高级别的肿瘤分级（OR 3.63，95%CI 2.55-5.16，P<0.01）以及更多的T淋巴细胞浸润（OR 5.55，95%CI 2.86-10.76，P<0.01）相关。未观察到明显的发表偏倚，敏感性分析表明我们的结果具有稳健性。我们的荟萃分析结果表明，高PD-L1表达可能是肉瘤患者不良临床病理特征和预后不良的有价值的预测生物标志物。
