| Siwen Liu,Rong Ma,Haixia Cao,Dan Chen,Changwen Jing,Zhuo Wang,Junying Zhang,Yang Wu,Jifeng Feng,Jianzhong Wu. Prognostic significance of PD-L1 expression in patients with colorectal cancer: a meta-analysis. Oncol Transl Med, 2019, 5: 68-74. |
| 结直肠癌患者PD-L1表达对临床预后的意义-Meta分析 |
| Prognostic significance of PD-L1 expression in patients with colorectal cancer: a meta-analysis |
| Received:October 23, 2018 Revised:May 16, 2019 |
| DOI：10.1007/s10330-018-0312-2 |
| 中文关键词: 结直肠癌；PD-L1；预后；Meta分析 |
| 英文关键词: ?colorectal cancer (CRC); programmed cell death ligand-1 (PD-L1); prognosis; Meta-analysis |
| 基金项目: |
| Author Name | Affiliation | E-mail | | Siwen Liu | Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research ?& The Affiliated Cancer Hospital of Nanjing Medical University | siwenliu1989@126.com | | Rong Ma | Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research& The Affiliated Cancer Hospital of Nanjing Medical University | | | Haixia Cao | Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research ?& The Affiliated Cancer Hospital of Nanjing Medical University | | | Dan Chen | Jiangsu Cancer Hospital DdDd Jiangsu Institute of Cancer Research ?DdDd The Affiliated Cancer Hospital of Nanjing Medical University | | | Changwen Jing | Jiangsu Cancer Hospital DdDd Jiangsu Institute of Cancer Research ?DdDd The Affiliated Cancer Hospital of Nanjing Medical University | | | Zhuo Wang | Jiangsu Cancer Hospital DdDd Jiangsu Institute of Cancer Research ?DdDd The Affiliated Cancer Hospital of Nanjing Medical University | | | Junying Zhang | Jiangsu Cancer Hospital DdDd Jiangsu Institute of Cancer Research ?DdDd The Affiliated Cancer Hospital of Nanjing Medical University | | | Yang Wu | Research Center for Clinical Oncology, Jiangsu Cancer Hospital DdDd Jiangsu Institute of Cancer Research ?DdDd The Affiliated Cancer Hospital of Nanjing Medical University | | | Jifeng Feng* | Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated ?Cancer Hospital of Nanjing Medical University | | | Jianzhong Wu | ?Jiangsu Cancer Hospital DdDd Jiangsu Institute of Cancer Research DdDd The Affiliated Cancer Hospital of Nanjing Medical University | |
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| 中文摘要: |
| 背景：PD-1或其配体（PD-L1）的表达与结直肠癌（CRC）患者生存率之间的关系仍存在争议。因此，我们进行了Meta分析，以探讨PD-L1在CRC中的表达及其对临床预后价值。
方法：在PubMed、Medline、Cochrane文库和EMBASE数据库中检索所有评价PD-L1表达和CRC患者生存率的研究。提取总生存率（OS）危险比（HRs）和95%置信区间（CI），评价PD-L1表达对CRC患者生存的影响。Meta分析的结果基于随机效应模型进行，同时进行亚组分析。
结果：纳入了7项研究，根据PD-L1表达状况分层。与PD-L1阴性表达的CRC患者相比，PD-L1阳性表达的CRC患者的总体生存率显著降低（HR=1.43，95%CI：1.07-1.92；P=0.02）。在亚组分析中，H-score评分系统和染色细胞百分率均显示，PD-L1表达与预后不良显著相关（HR=1.90，95%CI：1.38-2.62，P<0.01；HR=1.81，95%CI：1.08-3.03，P=0.02）。使用兔抗PD-L1抗体时，PD-L1阴性组存活率明显增高(HR=1.92;95%CI,1.40-2.63;P<0.01)。此外，当使用多克隆抗体时，PD-L1表达与预后不良显著相关（HR=1.84；95%CI，1.30-2.61；P<0.01）。
结论：Meta分析显示PD-L1表达状态是影响CRC患者预后的重要因素。PD-L1阳性表达与CRC患者的预后较差有关。不同的免疫组织化学评价方法可能部分解释了这种矛盾的结果。因此，需要更多的大样本研究来探讨PD-L1在CRC患者中表达的预后价值。 |
| 英文摘要: |
| ?Background The association between the expression of programmed cell death 1 (PD-1) or its ligand
[programmed cell death ligand-1 (PD-L1)] and colorectal cancer (CRC) survival rates remains unclear.
Thus, we conducted a meta-analysis to investigate the prognostic value of PD-L1 expression in CRC
patients.
Methods All eligible studies related to evaluation of PD-L1 expression and survival of CRC patients were
searched in PubMed, Medline, Cochrane library, and the EMBASE database. Hazard ratios (HRs) and 95%
confidence intervals (CI) of overall survival (OS) were examined to assess the effect of PD-L1 expression
on the survival of CRC patients. The outcomes of this meta-analysis were synthesized based on random-
effects model. Subgroup analyses were also performed.
Results Seven studies, wherein OS data were stratified according to the expression status of PD-L1,
were analyzed. CRC patients showing positive PD-L1 expression were associated with significantly poorer
prognoses in terms of overall survival, compared with those displaying negative PD-L1 expression (HR
= 1.43, 95% CI: 1.07–1.92; P = 0.02). In the subgroup analyses, H-scores as well as the percentage of
stained cells indicated that PD-L1 expression was significantly associated with poor prognosis (HR = 1.90,
95% CI: 1.38–2.62, P < 0.01; HR = 1.81, 95% CI: 1.08–3.03, P = 0.02). Immunohistochemical staining,
utilizing a rabbit anti-PD-L1 antibody, revealed significantly superior survival in the PD-L1 negative group
compared with the PD-L1 positive expression group (HR = 1.92; 95% CI, 1.40-2.63; P < 0.01). Moreover,
PD-L1 expression was significantly associated with poor prognosis when polyclonal antibodies were used
(HR = 1.84; 95% CI, 1.30–2.61; P < 0.01).
Conclusion Our meta-analysis indicated that PD-L1 expression status is a significant prognostic factor for
CRC patients. Positive PD-L1 expression was associated with worse CRC survival. Evaluation via different
immunohistochemistry based techniques may partly account for the contradictory results. Therefore, further
investigative studies using larger sample sizes are felt to be needed to elucidate the prognostic value of
PD-L1 expression in CRC patients. |
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