The clinicopathological features and prognosis of primary pulmonary lymphoepithelioma-like carcinoma: A systematic review and meta-analysis.
The clinicopathological features and prognosis of primary pulmonary lymphoepithelioma-like carcinoma: A systematic review and meta-analysis.
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DOI：
10.1371/journal.pone.0240729
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发表时间：
2020
期刊：
影响因子：
3.7
通讯作者：
Lin F
中科院分区：
文献类型：
--
作者：
Tang L;Chen N;He W;Zhou J;Zhang J;Lin Z;Wang Z;Hao J;Lin F
原发性肺淋巴上皮瘤样癌（PPLELC）是一种稀疏的未分类肺癌亚型。LELC的临床病理特征、预后因素和多模式治疗方案尚无定论。我们进行了系统回顾和荟萃分析，以解决当前知识的这一缺陷。我们检索了PubMed、Embase和Web of Science，筛选了截至2020年9月9日关于LELC临床特征和预后因素的研究。建立固定效应和随机效应模型，以95%置信区间（CI）表示合并的风险比（HR）和优势比（OR）。纳入研究的质量和异质性也被仔细评估。本系统综述和荟萃分析包括13项回顾性研究，共1294例患者。程序性细胞死亡配体1 （PD-L1）在PPLELC中的表达率从63.3%到75.8%不等。PD-L1阳性表达在60岁以下的患者中更为常见（OR = 2.16, 95%CI: 1.19-3.89, P = 0.01），与PD-L1阴性表达相比，PD-L1阳性表达与较差的无病生存（DFS）相关（HR = 2.99, 95%CI: 1.23-7.28, P = 0.02）。汇总结果显示，分期是总生存期（OS）和DFS的预后因素。此外，男性患者（HR = 0.56, 95%CI: 0.33-0.95, P = 0.03）和放疗患者（HR = 0.46, 95%CI: 0.22-0.96, P = 0.04）的PPLELC预后明显较好。PD-L1在PPLELC患者中表达较高。与年龄在60岁以下及不良的DFS显著相关。分期和性别可能是OS的预后因素。放疗可能是治疗PPLELC的有效方法。
Primary pulmonary lymphoepithelioma-like carcinoma (PPLELC) was a sparse subtype of unclassified lung cancer. The clinicopathologic features, prognostic factors and multimodality treatment regimens of LELC remain inconclusive. We conducted this systematic review and meta-analysis to address this deficit in current knowledge. We searched PubMed, Embase, and Web of Science to filtrate studies investigating on clinical features and prognostic factors of LELC up to Sep 9th, 2020. Fixed and random effect models were generated to present the incorporated hazard ratios (HR) and odds ratios (OR) with 95% confidence intervals (CI). The quality and heterogeneity of the included studies were also evaluated carefully. This systematic review and meta-analysis included 13 retrospective studies with a total of 1294 patients. The incidence of programmed cell death-ligand 1 (PD-L1) expression in PPLELC varied from 63.3% to 75.8%. Positive PD-L1 expression was more likely to be found in patients under 60 years old (OR = 2.16, 95%CI: 1.19–3.89, P = 0.01) and was associated with worse disease-free survival (DFS) compared with negative PD-L1 expression (HR = 2.99, 95%CI: 1.23–7.28, P = 0.02). The pooled results showed that stage was the prognostic factor for both overall survival (OS) and DFS. Moreover, a significantly better outcome of PPLELC was observed in men (HR = 0.56, 95%CI: 0.33–0.95, P = 0.03) and patients who received radiation (HR = 0.46, 95%CI: 0.22–0.96, P = 0.04). PD-L1 expression was high in PPLELC patients. It was significantly associated with age under 60 and the unfavorable DFS. Stage and gender could be the prognostic factor for OS. Radiation could be the effective therapy for PPLELC.