Yang Hong-Chang, Fu Cheng-Feng, Qiao Li-Jun, Long Gen-He, Yang Li-Fen, Yao Biao
Department of Gastroenterology, Longgang Central Hospital of Shenzhen, Shenzhen 518100, Guangdong Province, China.
Department of Oncology, Tongren People's Hospital, Tongren 554300, Guizhou Province, China.
World J Clin Oncol. 2025 Apr 24;16(4):102397. doi: 10.5306/wjco.v16.i4.102397.
Gastric cancer (GC) is one of the most common malignancies worldwide, and (HP) infection is a well-established risk factor for its development. Programmed death-ligand 1 (PD-L1) expression is a crucial biomarker for predicting the efficacy of immune checkpoint inhibitors in cancer treatment. While HP infection and PD-L1 expression in GC may be linked, the relationship between them remains unclear, in part because there have been conflicting results reported from various studies.
To perform a meta-analysis to assess the relationship between HP and PD-L1 expression in patients with GC.
A systematic literature review was conducted using PubMed, Embase, Cochrane Library, and Web of Science databases. Observational studies that examined the association between HP infection and PD-L1 expression in patients with GC were included. Odds ratios and 95% confidence intervals were calculated to estimate the association. Heterogeneity was assessed using Cochrane's test and statistic. A random-effects model was used due to significant heterogeneity across studies.
Fourteen studies involving a total of 3069 patients with GC were included. The pooled analysis showed a significant association between HP infection and increased PD-L1 expression in GC tissues (odd ratio = 1.69, 95% confidence interval: 1.24-2.29, < 0.001, = 59%). Sensitivity analyses confirmed the robustness of these findings. Subgroup analyses did not show significant variation based on geographic region, sample size, or method of PD-L1 assessment. Publication bias was minimal, as shown by funnel plots and Egger's regression test.
HP infection is associated with increased PD-L1 expression in GC, suggesting that HP status may influence the response to programmed cell death protein 1/PD-L1 blockade therapy.
胃癌（GC）是全球最常见的恶性肿瘤之一，幽门螺杆菌（HP）感染是其发病的一个公认风险因素。程序性死亡配体1（PD-L1）表达是预测免疫检查点抑制剂在癌症治疗中疗效的关键生物标志物。虽然GC中的HP感染与PD-L1表达可能有关联，但它们之间的关系仍不清楚，部分原因是各项研究报告的结果相互矛盾。
进行一项荟萃分析，以评估GC患者中HP与PD-L1表达之间的关系。
使用PubMed、Embase、Cochrane图书馆和Web of Science数据库进行系统的文献综述。纳入了检查GC患者中HP感染与PD-L1表达之间关联的观察性研究。计算优势比和95%置信区间以估计这种关联。使用Cochrane's Q检验和I²统计量评估异质性。由于各研究间存在显著异质性，故采用随机效应模型。
纳入了14项研究，共3069例GC患者。汇总分析显示，HP感染与GC组织中PD-L1表达增加之间存在显著关联（优势比 = 1.69，95%置信区间：1.24 - 2.29，P < 0.001，I² = 59%）。敏感性分析证实了这些发现的稳健性。亚组分析未显示基于地理区域、样本量或PD-L1评估方法的显著差异。漏斗图和Egger回归检验显示，发表偏倚最小。
HP感染与GC中PD-L1表达增加有关，提示HP状态可能影响程序性细胞死亡蛋白1/PD-L1阻断疗法的疗效。
