Department of General Surgery, Tangdu Hospital, The Air Force Medical University, Xi'an, 710038, China.
Curr Med Chem. 2024;31(21):3198-3216. doi: 10.2174/0109298673263784230922060257.
The expression level of programmed death ligand-1(PD-L1) in patients with gastric cancer is the key to determining the use of immune drugs. The relationship between PD-L1 expression level and clinical characteristics is worth exploring.
By setting the search terms correlated to PD-L1 and gastric cancer, a nearly comprehensive search was carried out in four major databases, and the deadline for searching was September 1, 2022. The retrieved documents were further screened by strict inclusion and exclusion criteria after removing the duplication. Next, the quality of the included studies was evaluated with the Newcastle-Ottawa Scale (NOS) scale. Finally, the STATA15.1 software was used to process data and draw plots, and the odds ratios (ORs) were adopted to assess the pooled effect size.
A total of 85 works of literature were included in this study through screening strictly, and detailed data were extracted after evaluating the quality of the literature. The process of analysis was conducted in the whole population, Asia-Africa population, European and American population, and Asian population with CPS≥1, amd all found that the expression of PD-L1 in gastric cancer was correlated with age, tumor size, EBV infection, Her-2 expression and microsatellite status. However, the subgroup of the region also found some differences in Asian and Western regions, which was interesting and worth studying further. The included research of this study did not have significant publish bias.
After careful analysis, this study found that age (>60 years), tumor size (>5cm), EBV infection (+), Her-2 expression (+), microsatellite status (MSI), and mismatch repair status (dMMR) were risk factors for positive expression of PD-L1 in gastric cancer.
胃癌患者程序性死亡配体-1（PD-L1）的表达水平是决定使用免疫药物的关键。探讨 PD-L1 表达水平与临床特征的关系具有重要意义。
通过设定与 PD-L1 和胃癌相关的检索词，在四个主要数据库中进行了近乎全面的检索，检索截止日期为 2022 年 9 月 1 日。在去除重复项后，进一步通过严格的纳入和排除标准筛选检索到的文献。然后，使用纽卡斯尔-渥太华量表（NOS）评估纳入研究的质量。最后，使用 STATA15.1 软件处理数据并绘制图表，采用比值比（OR）评估汇总效应量。
通过严格筛选，共纳入 85 篇文献进行研究，并对文献质量进行评估后提取详细数据。在全人群、亚非人群、欧美人群和 CPS≥1 的亚洲人群中进行了分析过程，均发现 PD-L1 在胃癌中的表达与年龄、肿瘤大小、EBV 感染、Her-2 表达和微卫星状态有关。然而，亚组分析还发现亚洲和西方人群在某些方面存在差异，这很有趣，值得进一步研究。本研究纳入的研究没有显著的发表偏倚。
经过仔细分析，本研究发现年龄（>60 岁）、肿瘤大小（>5cm）、EBV 感染（+）、Her-2 表达（+）、微卫星状态（MSI）和错配修复状态（dMMR）是 PD-L1 在胃癌中阳性表达的危险因素。
