Zhou Zi-Yu, Liu Shao-Ru, Xu Lei-Bo, Liu Chao, Zhang Rui
Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation and Department of Biliary-Pancreatic Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.
J Clin Transl Hepatol. 2021 Dec 28;9(6):889-897. doi: 10.14218/JCTH.2021.00056. Epub 2021 May 18.
The efficacy of targeted programmed cell death 1/programmed death ligand 1 (PD-1/PD-L1) monoclonal antibodies (mAbs) has been confirmed in many solid malignant tumors. The overexpression of PD-1/PD-L1 serves as a biomarker to predict prognosis and clinical progression. However, the role of PD-1 in patients with hepatitis B virus-related hepatocellular carcinoma (HBV-HCC) remains indeterminate. Given that HBV is the most important cause for HCC, this study aimed to investigate the prognostic and clinicopathological value of PD-1 in HBV-HCC via a meta-analysis.
We searched PubMed, Embase, Scopus, the Cochrane Library, Web of Science and Google Scholar up to January 2021 for studies on the correlation between clinicopathology/prognosis and PD-1 in patients with HBV-HCC. The pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated to investigate the prognostic significance of PD-1 expression. The odds ratios (ORs) and 95% CIs were determined to explore the association between PD-1 expression and clinicopathological features.
Our analysis included seven studies with 658 patients, which showed that high PD-1 expression was statistically correlated with poorer overall survival (HR=2.188, 95% CI: [1.262-3.115], <0.001) and disease-free survival (HR=2.743, 95% CI: [1.980-3.506], <0.001). PD-1 overexpression was correlated with multiple tumors (OR=2.268, 95% CI: [1.209-4.257], =0.011), high level of alpha fetoprotein (AFP; OR=1.495, 95% CI: [1.005-2.223], =0.047) and advanced Barcelona Clinic Liver Cancer (BCLC) stage (OR=3.738, 95% CI: [2.101-6.651], <0.001).
Our meta-analysis revealed that the high level of PD-1 expression was associated with multiple tumors, high level of AFP and advanced BCLC stage. It significantly predicted a poor prognosis of HBV-HCC, which suggests that anti-PD-1 therapy for HBV-HCC patients is plausible.
靶向程序性细胞死亡蛋白1/程序性死亡配体1（PD-1/PD-L1）单克隆抗体（mAb）在多种实体恶性肿瘤中的疗效已得到证实。PD-1/PD-L1的过表达作为预测预后和临床进展的生物标志物。然而，PD-1在乙型肝炎病毒相关肝细胞癌（HBV-HCC）患者中的作用仍不明确。鉴于HBV是HCC的最重要病因，本研究旨在通过荟萃分析探讨PD-1在HBV-HCC中的预后及临床病理价值。
我们检索了截至2021年1月的PubMed、Embase、Scopus、Cochrane图书馆、Web of Science和谷歌学术，以查找关于HBV-HCC患者临床病理/预后与PD-1相关性的研究。计算合并风险比（HR）和95%置信区间（CI），以研究PD-1表达的预后意义。确定比值比（OR）和95%CI，以探讨PD-1表达与临床病理特征之间的关联。
我们的分析纳入了7项研究共658例患者，结果显示PD-1高表达与较差的总生存期（HR=2.188，95%CI：[1.262-3.115]，<0.001）和无病生存期（HR=2.743，95%CI：[1.980-3.506]，<0.001）在统计学上相关。PD-1过表达与多发肿瘤（OR=2.268，95%CI：[1.209-4.257]，=0.011）、甲胎蛋白（AFP）高水平（OR=1.495，95%CI：[1.005-2.223]，=0.047）及巴塞罗那临床肝癌（BCLC）分期晚期（OR=3.738，95%CI：[2.101-6.651]，<0.001）相关。
我们的荟萃分析显示，PD-1高表达与多发肿瘤、AFP高水平及BCLC分期晚期相关。它显著预测了HBV-HCC的不良预后，这表明对HBV-HCC患者进行抗PD-1治疗是可行的。
