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不同程序性死亡配体1（PD-L1）表达模式和肿瘤浸润淋巴细胞在高级别浆液性卵巢癌中的预后作用：一项系统评价和荟萃分析

Prognostic role of different PD-L1 expression patterns and tumor-infiltrating lymphocytes in high-grade serous ovarian cancer: a systematic review and meta-analysis.

作者信息

Wang Ye-Min, Cai Wei, Xue Qing-Ming, Zhang Jin-Yao, Zhou Lv, Xiong Su-Yi, Deng Huan

机构信息

Department of Pathology, the Fourth Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.

Medical College, Nanchang University, Nanchang, Jiangxi, China.

出版信息

Front Immunol. 2023 Aug 15;14:1234894. doi: 10.3389/fimmu.2023.1234894. eCollection 2023.

DOI:10.3389/fimmu.2023.1234894

PMID:37654479

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10465691/

Abstract

BACKGROUND

The prognostic value of programmed cell death ligand 1 (PD-L1) expression and tumor-infiltrating lymphocytes (TILs) in high-grade serous ovarian cancer (HGSOC) remains a controversial topic in the research field. To comprehensively assess the importance of PD-L1 and TILs in this particular subtype of ovarian cancer, we performed a meta-analysis.

METHODS

We conducted a comprehensive search of PubMed, Embase, Scopus, Web of Science, and Cochrane Library databases up to December 25, 2022. The association between PD-L1, TILs, and survival outcomes was evaluated using the combined hazard ratios (HRs) and their corresponding 95% confidence intervals (CIs).

RESULTS

This meta-analysis comprised 11 trials involving a total of 1746 cases. The results revealed no significant association between PD-L1 expression in tumor cells (TCs) and overall survival (OS, HR = 0.76, 95% CI: 0.52-1.09, = 0.136) or progression-free survival (PFS, HR = 0.71, 95% CI: 0.4 -1.24, = 0.230). Nevertheless, a correlation was observed between PD-L1 expression in immune cells (ICs) and OS (HR = 0.73, 95% CI: 0.55-0.97, = 0.031). Furthermore, the presence of CD8 and PD-1 TILs was found to significantly enhance OS (HR = 0.70, 95% CI = 0.55-0.87, = 0.002; HR = 0.57, 95% CI = 0.40-0.80, = 0.001, respectively) and PFS (HR = 0.62, 95% CI = 0.41-0.92, = 0.019; HR = 0.52, 95% CI = 0.35-0.78, = 0.002, respectively), whereas the presence of CD3 and CD4 TILs was positively associated with OS (HR = 0.50, 95% CI = 0.29-0.87, = 0.014; HR = 0.55, 95% CI = 0.34-0.91, = 0.020, respectively).

CONCLUSION

This study indicates a positive correlation between ICs-derived PD-L1 and survival, while no significant correlation was observed between TCs-derived PD-L1 and prognosis. These results highlight the importance of studying PD-L1 expression in ICs as a prognostic predictor. In addition, the presence of TILs was found to significantly improve patient survival, suggesting that TILs may be a valuable prognostic biomarker.

SYSTEMATIC REVIEW REGISTRATION

https://www.crd.york.ac.uk/prospero/, identifier CRD42022366411.

摘要

背景

在高级别浆液性卵巢癌（HGSOC）中，程序性细胞死亡配体1（PD-L1）表达和肿瘤浸润淋巴细胞（TILs）的预后价值在研究领域仍是一个有争议的话题。为了全面评估PD-L1和TILs在这种特定亚型卵巢癌中的重要性，我们进行了一项荟萃分析。

方法

我们对截至2022年12月25日的PubMed、Embase、Scopus、Web of Science和Cochrane图书馆数据库进行了全面检索。使用合并风险比（HRs）及其相应的95%置信区间（CIs）评估PD-L1、TILs与生存结果之间的关联。

结果

这项荟萃分析包括11项试验，共1746例病例。结果显示，肿瘤细胞（TCs）中PD-L1表达与总生存期（OS，HR = 0.76，95% CI：0.52 - 1.09，P = 0.136）或无进展生存期（PFS，HR = 0.71，95% CI：0.4 - 1.24，P = 0.230）之间无显著关联。然而，免疫细胞（ICs）中PD-L1表达与OS之间存在相关性（HR = 0.73，95% CI：0.55 - 0.97，P = 0.031）。此外，发现CD8和PD-1 TILs的存在显著提高了OS（HR分别为0.70，95% CI = 0.55 - 0.87，P = 0.002；HR = 0.57，95% CI = 0.40 - 0.80，P = 0.001）和PFS（HR分别为0.62，95% CI = 0.41 - 0.92，P = 0.019；HR = 0.52，95% CI = 0.35 - 0.78，P = 0.002），而CD3和CD4 TILs的存在与OS呈正相关（HR分别为0.50，95% CI = 0.29 - 0.87，P = 0.014；HR = 0.55，95% CI = 0.34 - 0.91，P = 0.020）。