Li Wen, Zheng Qiaoling, Luo Xiaofeng, Zhang Xinyue, Zheng Xin, Yang Yinghong
Department of Pathology, Fujian Medical University Union Hospital, Fuzhou, China.
Fujian Institute of Hematology, Fujian Provincial Key Laboratory on Hematology, Fujian Medical University Union Hospital, Fuzhou, China.
Transl Cancer Res. 2023 Aug 31;12(8):2115-2127. doi: 10.21037/tcr-22-2569. Epub 2023 Aug 28.
Although programmed cell death ligand 1 (PD-L1) expression and function in hematologic malignancies have aroused extensive attention, its prognostic value for extranodal natural killer/T-cell lymphoma (ENKTL) is still unknown. Therefore, we conducted this meta-analysis to explore the predictive value of neoplastic PD-L1 expression for ENKTL.
The PubMed, Embase, Web of Science, and CNKI databases were searched to identify eligible observational studies reporting PD-L1 expression and survival outcomes of ENKTL patients. The search was conducted in accordance with the Meta-analyses Of Observative Studies in Epidemiology (MOOSE) guidelines. The pooled hazard ratios (HRs) and 95% confidence intervals (95% CIs) were adopted to analyze survival outcomes, and the odds ratios (ORs) and 95% CIs were adopted for clinicopathological parameters. Review Manager 5.3 and STATA 17.0 were used for statistical analysis. Potential publication bias was evaluated by funnel plot and Egger's test.
A total of 433 patients with ENKTL were included across seven studies. The pooled results showed no significant relationship between neoplastic PD-L1 expression and overall survival (OS) (HR =1.35, 95% CI: 0.49-3.75, P=0.559). We also performed subgroup analyses. However, increased PD-L1 expression was associated with a low international prognostic index (IPI) score of 0-1 (OR =2.46; 95% CI: 1.11-5.45, P=0.03), good performance status (OR =1.97; 95% CI: 1.11-3.51, P=0.02), and a good treatment effect (OR =2.61; 95% CI: 1.01-6.70, P=0.05).
PD-L1-positive expression in patients with ENKTL was correlated with favorable clinical features. Thus, PD-L1-positive expression appears to be a potential predictor of treatment benefits. Additional large-scale, high-quality studies are needed to further explore its predictive value.
尽管程序性细胞死亡配体1（PD-L1）在血液系统恶性肿瘤中的表达及功能已引起广泛关注，但其对结外自然杀伤/T细胞淋巴瘤（ENKTL）的预后价值仍不清楚。因此，我们进行了这项荟萃分析，以探讨肿瘤性PD-L1表达对ENKTL的预测价值。
检索PubMed、Embase、Web of Science和CNKI数据库，以识别报告ENKTL患者PD-L1表达和生存结果的符合条件的观察性研究。检索按照流行病学观察性研究的荟萃分析（MOOSE）指南进行。采用合并风险比（HR）和95%置信区间（95%CI）分析生存结果，采用比值比（OR）和95%CI分析临床病理参数。使用Review Manager 5.3和STATA 17.0进行统计分析。通过漏斗图和Egger检验评估潜在的发表偏倚。
七项研究共纳入433例ENKTL患者。汇总结果显示，肿瘤性PD-L1表达与总生存期（OS）之间无显著相关性（HR =1.35，95%CI：0.49-3.75，P=0.559）。我们还进行了亚组分析。然而，PD-L1表达增加与国际预后指数（IPI）评分为0-1较低（OR =2.46；95%CI：1.11-5.45，P=0.03）、良好的体能状态（OR =1.97；95%CI：1.11-3.51，P=0.02）以及良好的治疗效果（OR =2.61；95%CI：1.01-6.70，P=0.05）相关。
ENKTL患者的PD-L1阳性表达与良好的临床特征相关。因此，PD-L1阳性表达似乎是治疗获益的潜在预测指标。需要更多大规模、高质量的研究来进一步探索其预测价值。
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