Ruan Jian, Zhao Zhihong, Qian Yuting, Xu Ruilian, Liao Guixiang, Kong Feng-Ming Spring
The Second Clinical Medical College, Jinan University, Guangdong, China.
Department of Nephrology, Shenzhen People's Hospital, The Second Clinical Medical College, Jinan University, Guangdong, China.
Front Oncol. 2023 Jul 13;13:1170220. doi: 10.3389/fonc.2023.1170220. eCollection 2023.
The prognostic role of soluble programmed death ligand 1 (sPD-L1) in digestive system cancers (DSCs) remains inconclusive. This study aimed to explore the predictive value of sPD-L1 expression in DSCs.
Comprehensive searches were run on the electronic databases (PubMed, Web of Science, EMBASE, and the Cochrane Library) to identify studies that assessed the prognostic role of sPD-L1 in DSCs. Review Manager software (version 5.3) was used for all analyses. Pooled data for survival outcomes were measured as hazard ratios (HRs), 95% confidence intervals (CIs), and odds ratios and their 95% CIs.
The search identified 18 studies involving 2,070 patients with DSCs. The meta-outcome revealed that a high level of sPD-L1 was related to poorer overall survival (HR, 3.06; 95% CI: 2.22-4.22, p<0.001) and disease-free survival (HR, 2.53; 95% CI: 1.67-3.83, p<0.001) in DSCs. Individually, the prognostic significance of high level of sPD-L1 expression was the highest in hepatic cell carcinoma (HR, 4.76; p<0.001) followed by gastric cancer (HR=3.55, p<0.001).
sPD-L1 may be a prognostic factor in DSCs for overall survival and disease-free survival. Inflammatory cytokines, treatment approaches, and other factors may affect the expression of sPD-L1. Therefore, the prognostic value of sPD-L1 for recurrence and metastasis should be further investigated. sPD-L1 may also predict response to treatment. Well-designed prospective studies with standard assessment methods should be conducted to determine the prognostic value of sPD-L1 in DSCs.
可溶性程序性死亡配体1（sPD-L1）在消化系统癌症（DSCs）中的预后作用尚无定论。本研究旨在探讨sPD-L1表达在DSCs中的预测价值。
对电子数据库（PubMed、Web of Science、EMBASE和Cochrane图书馆）进行全面检索，以识别评估sPD-L1在DSCs中预后作用的研究。所有分析均使用Review Manager软件（5.3版）。生存结局的汇总数据以风险比（HRs）、95%置信区间（CIs）、比值比及其95%CI进行测量。
检索确定了18项研究，涉及2070例DSCs患者。荟萃分析结果显示，高水平的sPD-L1与DSCs患者较差的总生存期（HR，3.06；95%CI：2.22-4.22，p<0.001）和无病生存期（HR，2.53；95%CI：1.67-3.83，p<0.001）相关。单独来看，高水平sPD-L1表达的预后意义在肝细胞癌中最高（HR，4.76；p<0.001），其次是胃癌（HR=3.55，p<0.001）。
sPD-L1可能是DSCs总生存期和无病生存期的预后因素。炎性细胞因子、治疗方法和其他因素可能影响sPD-L1的表达。因此，sPD-L1对复发和转移的预后价值应进一步研究。sPD-L1也可能预测治疗反应。应开展设计良好的前瞻性研究，并采用标准评估方法来确定sPD-L1在DSCs中的预后价值。
