Guo Xin, Zhang Yuelin, Jiao Hengxing, Miao Xingyu
Department of Neurosurgery, Shaanxi Provincial People's Hospital, Xi'an, China.
Department of Graduate Work, Hanguang Campus of Xi'an Medical University, Xi'an, China.
Front Oncol. 2022 Oct 12;12:925560. doi: 10.3389/fonc.2022.925560. eCollection 2022.
Glioblastoma (GBM) is a malignant brain tumor associated with high morbidity and mortality rates with a poor prognosis. In recent years, studies on prognostic markers such as programmed death ligand 1 (PD-L1) have increased; however, their conclusions remain controversial. Here, relevant literature was reviewed and a meta-analysis was performed to clarify the correlation between PD-L1 expression and overall survival (OS) in GBM.
The non-foundational literature on PD-L1 expression associated with OS in GBM up to February 2022 was searched in the PubMed, Metstr, Cochrane, and Web of Science databases. Literature was rigorously screened according to inclusion and exclusion criteria, the total hazard ratio (HR), and corresponding 95% confidence intervals (CIs).
Calculating the combined HR value and corresponding 95% CI of HR=1.124 (95% CI: 1.047-1.201, P=0.000, I2 (I-squared)=48.8%), it was shown that PD-L1 expression was significantly associated with low OS in GBM patients. Although I2 = 48.8% < 50%, to make the results more credible, in the cutoff values ≥10% subgroup HR=1.37 (95% CI: 1.07-1.67, P=0.000, I2 = 0%), which was also the result found in the first meta-analysis. In contrast, in the cutoff value ≥5% subgroup HR=1.14 (95% CI: 0.98-1.30, P=0.000, I2 = 59.8%) and in the cutoff value median PD-L1 expression levels subgroup HR=1.05 (95% CI: 0.92-1.18, P=0.000, I2 = 0%), indicating that PD-L1 expression was not associated with low OS in GBM. Furthermore, in four studies, we found no significant correlation between PD-L1 expression and the progression-free survival of GBM (HR=1.14, 95% CI:0.40-1.88, P=0.03, I2 = 29.3%).
PD-L1 expression was significantly associated with low OS in GBM patients; however, this result needs to be interpreted with caution and requires a large, multicenter clinical study in patients with similar baseline data for further evaluation.
胶质母细胞瘤（GBM）是一种恶性脑肿瘤，发病率和死亡率高，预后较差。近年来，关于程序性死亡配体1（PD-L1）等预后标志物的研究有所增加；然而，其结论仍存在争议。在此，对相关文献进行综述并进行荟萃分析，以阐明GBM中PD-L1表达与总生存期（OS）之间的相关性。
在PubMed、Metstr、Cochrane和Web of Science数据库中检索截至2022年2月与GBM中OS相关的PD-L1表达的非基础文献。根据纳入和排除标准、总风险比（HR）及相应的95%置信区间（CI）对文献进行严格筛选。
计算合并HR值及相应的95%CI，HR=1.124（95%CI：1.047-1.201，P=0.000，I2（I-平方）=48.8%），结果显示GBM患者中PD-L1表达与低OS显著相关。虽然I2=48.8%<50%，但为使结果更可信，在截断值≥10%亚组中HR=1.37（95%CI：1.07-1.67，P=0.000，I2=0%），这也是首次荟萃分析得出的结果。相比之下，在截断值≥5%亚组中HR=1.14（95%CI：0.98-1.30，P=0.000，I2=59.8%），在截断值为PD-L1表达水平中位数亚组中HR=1.05（95%CI：0.92-1.18，P=0.000，I2=0%），表明GBM中PD-L1表达与低OS无关。此外，在四项研究中，我们发现PD-L1表达与GBM的无进展生存期之间无显著相关性（HR=1.14，95%CI：0.40-1.88，P=0.03，I2=29.3%）。
GBM患者中PD-L1表达与低OS显著相关；然而，这一结果需要谨慎解读，且需要在具有相似基线数据的患者中进行大规模、多中心临床研究以作进一步评估。
