Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
J Invest Dermatol. 2021 Sep;141(9):2161-2169. doi: 10.1016/j.jid.2021.02.741. Epub 2021 Mar 24.
The majority of cutaneous squamous cell carcinomas are treated by surgical removal; however, approximately 4% of tumors will metastasize. Molecular expression testing may improve accuracy in estimating the prognosis and defining the mechanisms important in the disease progression, which may impact response to therapy. Using PubMed (MEDLINE) and EMBASE, a systematic review was performed to evaluate studies published from January 2005 to August 2019 reporting tumor protein or RNA expression along with either outcomes (metastasis or death) or a comparison of primary with metastatic tumor samples. Inclusion criteria were met by 45 studies containing 81 comparisons of 44 distinct proteins and 25 microRNAs. On meta-analysis of studies analyzing primary tumor samples in terms of later outcomes, high primary tumor expression of PD-L1 (OR = 2.34, 95% confidence interval = 1.09-5.02, P = 0.030), EGFR (OR = 2.57, 95% confidence interval = 1.24-5.33, P = 0.011), and podoplanin (OR = 2.33, 95% confidence interval = 1.00-5.41, P = 0.049) conferred increased odds for metastasis. In comparison, metastatic tissue was more likely to have a high expression of PD-L1 than primary tissue (OR = 3.13, 95% confidence interval = 1.00-9.75, P = 0.049). Further studies are needed to confirm whether testing for PD-L1, EGFR, and podoplanin expression aids in cutaneous squamous cell carcinomas prognostic estimation of metastasis or death or predicts response to therapy.
大多数皮肤鳞状细胞癌通过手术切除进行治疗；然而，约有 4%的肿瘤会转移。分子表达测试可能会提高预后评估的准确性，并确定疾病进展中重要的机制，这可能会影响治疗反应。通过使用 PubMed（MEDLINE）和 EMBASE，对 2005 年 1 月至 2019 年 8 月期间发表的报告肿瘤蛋白或 RNA 表达以及转移或死亡结果的研究进行了系统评价，或比较原发性和转移性肿瘤样本的研究。共有 45 项研究符合纳入标准，其中包含 81 项 44 种不同蛋白和 25 种 microRNA 的比较。对分析原发性肿瘤样本的研究进行荟萃分析，发现 PD-L1（OR = 2.34，95%置信区间 = 1.09-5.02，P = 0.030）、EGFR（OR = 2.57，95%置信区间 = 1.24-5.33，P = 0.011）和 podoplanin（OR = 2.33，95%置信区间 = 1.00-5.41，P = 0.049）在原发性肿瘤中的高表达与转移的几率增加相关。相比之下，转移性组织比原发性组织更有可能表达高水平的 PD-L1（OR = 3.13，95%置信区间 = 1.00-9.75，P = 0.049）。需要进一步的研究来证实 PD-L1、EGFR 和 podoplanin 表达的检测是否有助于预测皮肤鳞状细胞癌转移或死亡的预后，或预测对治疗的反应。
