程序性死亡配体1表达对早期切除的非小细胞肺癌预后的影响：文献的荟萃分析
The Impact of Programmed Death-Ligand 1 Expression on the Prognosis of Early Stage Resected Non-Small Cell Lung Cancer: A Meta-Analysis of Literatures.
作者信息
Shi Tao, Zhu Shuai, Guo Hengjuan, Li Xiongfei, Zhao Shikang, Wang Yanye, Lei Xi, Huang Dingzhi, Peng Ling, Li Ziming, Xu Song
机构信息
Precision Medicine Center, Tianjin Medical University General Hospital, Tianjin, China.
Department of Lung Cancer Surgery, Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment, Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin, China.
出版信息
Front Oncol. 2021 Feb 23;11:567978. doi: 10.3389/fonc.2021.567978. eCollection 2021.
INTRODUCTION
Previous studies have demonstrated that programmed cell death-ligand 1 (PD-L1) serves as biomarker for poor prognosis and survival in advanced-stage non-small cell lung cancer (NSCLC) patients. However, the merit of PD-L1 expression to predict the prognosis of early stage NSCLC patients who underwent complete resection remains controversial. In the present study, we performed a meta-analysis to investigate the relationship between PD-L1 expression and prognosis in patients with early stage resected NSCLC.
METHODS
Electronic databases, including PubMed, EMBASE, and the Cochrane Library, were searched until July 23 2020 for studies evaluating the expression of PD-L1 and the prognosis of resected NSCLCs. Hazard ratios (HRs) with 95% confidence intervals (CIs) of overall survival (OS) and disease-free survival (DFS) were pooled and analyzed. Heterogeneity and publication bias analyses were also assessed.
RESULTS
A total of 15 studies involving 3,790 patients were considered in the present meta-analysis. The pooled HR indicated that PD-L1 expression related to a much shorter DFS (HR = 1.56, 95% CI: 1.18-2.05, p < 0.01), as well a significantly worse OS (HR = 1.68, 95% CI: 1.29-2.18, p < 0.01). Furthermore, our analysis indicated that PD-L1 expression was significantly associated with gender (male female: OR = 1.27, 95% CI:1.01-1.59, p = 0.038), histology (ADC . SCC: OR = 0.54, 95% CI:0.38-0.77, p = 0.001), TNM stage (I . II-III: OR = 0.45, 95% CI:0.34-0.60, p = 0.000), smoking status (Yes No: OR = 1.43, 95% CI:1.14-1.80, p = 0.002) and lymph node metastasis (N+ N-: OR = 1.97, 95% CI:1.26-3.08, p = 0.003).
CONCLUSIONS
The results of this meta-analysis suggest that PD-L1 expression predicts an unfavorable prognosis in early stage resected NSCLCs. The role of personalized anti-PD-L1/PD-1 immunotherapy in the adjuvant settings of resected NSCLC warrants further investigation.
引言
既往研究表明，程序性细胞死亡配体1（PD-L1）是晚期非小细胞肺癌（NSCLC）患者预后不良和生存的生物标志物。然而，PD-L1表达对接受根治性切除的早期NSCLC患者预后的预测价值仍存在争议。在本研究中，我们进行了一项荟萃分析，以探讨PD-L1表达与早期切除的NSCLC患者预后之间的关系。
方法
检索电子数据库，包括PubMed、EMBASE和Cochrane图书馆，直至2020年7月23日，以查找评估PD-L1表达与切除的NSCLC患者预后的研究。汇总并分析总生存期（OS）和无病生存期（DFS）的风险比（HR）及95%置信区间（CI）。还评估了异质性和发表偏倚分析。
结果
本荟萃分析共纳入15项研究，涉及3790例患者。汇总的HR表明，PD-L1表达与更短的DFS相关（HR = 1.56，95%CI：1.18-2.05，p < 0.01），以及显著更差的OS（HR = 1.68，95%CI：1.29-2.18，p < 0.01）。此外，我们的分析表明，PD-L1表达与性别（男性对女性：OR = 1.27，95%CI：1.01-1.59，p = 0.038）、组织学类型（腺癌对鳞癌：OR = 0.54，95%CI：0.38-0.77，p = 0.001）、TNM分期（I期对II-III期：OR = 0.45，95%CI：0.34-0.60，p = 0.000）、吸烟状态（是对否：OR = 1.43，95%CI：1.14-1.80，p = 0.002）和淋巴结转移（N+对N-：OR = 1.97，95%CI：1.26-3.08，p = 0.003）显著相关。
结论
本荟萃分析结果表明，PD-L1表达可预测早期切除的NSCLC患者预后不良。个性化抗PD-L1/PD-1免疫治疗在切除的NSCLC辅助治疗中的作用值得进一步研究。
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