Huang Lijun, He Qiurong, Liu Liping, Huang Jie, Chang Fan
West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
Department of Laboratory Medicine, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
Clin Transl Oncol. 2025 Mar;27(3):1288-1298. doi: 10.1007/s12094-024-03620-3. Epub 2024 Aug 23.
The predictive role of exosomal programmed cell death ligand l (exoPD-L1) in prognosis has been studied extensively; however, there is still no consensus.
Three databases, including EMBASE, PubMed, and Web of Science, were searched through January 4, 2024. The pooled hazard ratios (HRs) with 95% confidence intervals (95%CIs) were used to identify the relationship between circulating exoPD-L1 and prognosis.
15 studies with 1091 patients with cancer were included in this statistical analysis. High exoPD-L1 level was correlated with shorter progression-free survival (PFS) (HR = 2.58, 95% CI: 1.75-3.81) and overall survival (OS) (HR = 1.61, 95% CI: 1.32-1.98). Meanwhile, we found that dynamic upregulation of circulating exoPD-L1 in the early stages of immunotherapy was a favorable factor for prognosis (PFS: HR = 0.34, 95% CI: 0.23-0.51; OS: HR = 0.21, 95% CI: 0.13-0.26).
Circulating exoPD-L1 may be a valuable prognostic indicator for patients with cancer and monitoring its changes in the early stages of immunotherapy might be used to predict tumor response and clinical outcome. This conclusion may not apply to superficial tumors.
外泌体程序性细胞死亡配体1（exoPD-L1）在预后中的预测作用已得到广泛研究；然而，仍未达成共识。
检索了包括EMBASE、PubMed和Web of Science在内的三个数据库，检索截至2024年1月4日的数据。采用合并风险比（HRs）及95%置信区间（95%CIs）来确定循环exoPD-L1与预后之间的关系。
本统计分析纳入了15项研究中的1091例癌症患者。exoPD-L1水平高与无进展生存期（PFS）缩短（HR = 2.58，95%CI：1.75 - 3.81）和总生存期（OS）缩短（HR = 1.61，95%CI：1.32 - 1.98）相关。同时，我们发现免疫治疗早期循环exoPD-L1的动态上调是预后的有利因素（PFS：HR = 0.34，95%CI：0.23 - 0.51；OS：HR = 0.21，95%CI：0.13 - 0.26）。
循环exoPD-L1可能是癌症患者有价值的预后指标，在免疫治疗早期监测其变化可用于预测肿瘤反应和临床结局。这一结论可能不适用于浅表肿瘤。
