Clinicopathological and Prognostic Value of Programmed Cell Death 1 Expression in Hepatitis B Virus-related Hepatocellular Carcinoma: A Meta-analysis.
Clinicopathological and Prognostic Value of Programmed Cell Death 1 Expression in Hepatitis B Virus-related Hepatocellular Carcinoma: A Meta-analysis.
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乙型肝炎病毒相关肝细胞癌中程序性细胞死亡 1 表达的临床病理学和预后价值：荟萃分析
DOI：
10.14218/jcth.2021.00056
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发表时间：
2021-12-28
影响因子：
3.6
通讯作者：
Zhang R
中科院分区：
文献类型：
--
作者：
Zhou ZY;Liu SR;Xu LB;Liu C;Zhang R
背景与目的靶向程序性细胞死亡1/程序性死亡配体1 （PD-1/PD-L1）单克隆抗体（mab）在许多实体恶性肿瘤中的疗效已得到证实。PD-1/PD-L1的过表达可作为预测预后和临床进展的生物标志物。然而，PD-1在乙型肝炎病毒相关性肝细胞癌（HBV-HCC）患者中的作用仍不确定。鉴于HBV是HCC最重要的病因，本研究旨在通过meta分析探讨PD-1在HBV-HCC中的预后和临床病理价值。方法：我们检索PubMed、Embase、Scopus、Cochrane Library、Web of Science和谷歌Scholar，检索截至2021年1月的关于HBV-HCC患者临床病理/预后与PD-1相关性的研究。计算合并风险比（hr）和95%置信区间（ci），探讨PD-1表达的预后意义。通过比值比（or）和95% ci来探讨PD-1表达与临床病理特征之间的关系。结果纳入7项研究，共658例患者，结果显示PD-1高表达与较差的总生存期（HR=2.188, 95% CI: [1.262-3.115], p<0.001）和无病生存期（HR=2.743, 95% CI: [1.980-3.506], p<0.001）有统计学相关性。PD-1过表达与多发性肿瘤（OR=2.268, 95% CI: [1.209 ~ 4.257], p=0.011）、高水平甲胎蛋白（AFP； OR=1.495, 95% CI: [1.005 ~ 2.223], p=0.047）、巴塞罗那临床肝癌（BCLC）晚期（OR=3.738, 95% CI: [2.101 ~ 6.651], p<0.001）相关。我们的荟萃分析显示，PD-1高水平表达与多发性肿瘤、AFP高水平和BCLC晚期相关。显著预测HBV-HCC预后不良，提示抗pd -1治疗HBV-HCC患者是可行的。
Background and Aims The efficacy of targeted programmed cell death 1/programmed death ligand 1 (PD-1/PD-L1) monoclonal antibodies (mAbs) has been confirmed in many solid malignant tumors. The overexpression of PD-1/PD-L1 serves as a biomarker to predict prognosis and clinical progression. However, the role of PD-1 in patients with hepatitis B virus-related hepatocellular carcinoma (HBV-HCC) remains indeterminate. Given that HBV is the most important cause for HCC, this study aimed to investigate the prognostic and clinicopathological value of PD-1 in HBV-HCC via a meta-analysis. Methods We searched PubMed, Embase, Scopus, the Cochrane Library, Web of Science and Google Scholar up to January 2021 for studies on the correlation between clinicopathology/prognosis and PD-1 in patients with HBV-HCC. The pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated to investigate the prognostic significance of PD-1 expression. The odds ratios (ORs) and 95% CIs were determined to explore the association between PD-1 expression and clinicopathological features. Results Our analysis included seven studies with 658 patients, which showed that high PD-1 expression was statistically correlated with poorer overall survival (HR=2.188, 95% CI: [1.262–3.115], p<0.001) and disease-free survival (HR=2.743, 95% CI: [1.980–3.506], p<0.001). PD-1 overexpression was correlated with multiple tumors (OR=2.268, 95% CI: [1.209–4.257], p=0.011), high level of alpha fetoprotein (AFP; OR=1.495, 95% CI: [1.005–2.223], p=0.047) and advanced Barcelona Clinic Liver Cancer (BCLC) stage (OR=3.738, 95% CI: [2.101–6.651], p<0.001). Conclusions Our meta-analysis revealed that the high level of PD-1 expression was associated with multiple tumors, high level of AFP and advanced BCLC stage. It significantly predicted a poor prognosis of HBV-HCC, which suggests that anti-PD-1 therapy for HBV-HCC patients is plausible.