Prognostic and clinicopathological significance of PD-L1 in patients with renal cell carcinoma: a meta-analysis based on 1863 individuals
Prognostic and clinicopathological significance of PD-L1 in patients with renal cell carcinoma: a meta-analysis based on 1863 individuals
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PD-L1 在肾细胞癌患者中的预后和临床病理学意义：基于 1863 名个体的荟萃分析
DOI：
10.1007/s10238-018-0488-3
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发表时间：
2018-05-01
影响因子：
4.6
通讯作者：
Niu, Yuanjie
中科院分区：
文献类型：
--
作者：
Wang, Zhun;Peng, Shuanghe;Niu, Yuanjie
PD-L1在肾癌(RCC)中的预后意义已在以往的研究中得到了研究，但结果仍存在争议。本荟萃分析的主要目的是探讨PD-L1在肾癌患者中的表达对预后和临床病理的意义。检索PubMed、Embase、Web of Science和Cochrane图书馆相关文献，比较PD-L1表达与肾癌预后的关系。从符合条件的研究中提取生存结果的风险比(HRs)和与PD-L1相关的临床参数的优势比(ORs)。异质性使用I2值进行评估。如果没有异质性的证据，则使用固定效应模型；否则，使用随机效应模型。采用Begg‘s漏斗图和Egger’s回归检验评价发表偏倚。对来自10项合格研究的1863名患者进行了分析。结果表明，PD-L1的表达与透明细胞肾癌(HR=2.76，95%CI：2.25~3.38，I2=814.4%，P<0.001)和非透明细胞肾癌(HR=22.77，95%CI：1.62~4.72，I2=0.28.8%，P<；0.001)患者总体生存率低有关。此外，PD-L1的表达与肿瘤原发分期(OR=1.76，95%CI：1.39~2.23；I2=956.3%)、区域淋巴结转移(OR=2.10，95%CI：1.48~2.98；I2=914.9%)、远处转移(OR=2.69，95%CI：2.05~3.54；I2=100.0%)、核分级(OR=1.72，95%CI：1.32~2.23；I2=79.4%)和组织学肿瘤坏死(OR=2.25，95%CI：1.59~3.18；I2=66.1%)。敏感性分析证实了结果的稳定性。Begg的漏斗图检验(P=0.276)和Egger的漏斗图检验(P=0.388)都证实纳入的研究中没有发表偏倚。本研究提示PD-L1的表达与肾癌患者的不良预后和晚期临床病理特征有关。
The prognostic significance of PD-L1 in renal cell carcinoma (RCC) had been investigated in previous studies; however, the results remain controversial. The primary aim of this meta-analysis was to investigate the prognostic and clinicopathological significance of the PD-L1 expression in patients with RCC. Relevant literature was identified form PubMed, Embase, Web of Science and Cochrane library, which compared the prognostic significance between PD-L1 expression and RCC. Hazard ratios (HRs) for survival outcomes and odds ratios (ORs) for clinical parameters associated with PD-L1 were extracted from eligible studies. Heterogeneity was assessed using theI2value. The fixed-effects model was used if there was no evidence of heterogeneity; otherwise, the random-effects model was used. Publication bias was evaluated using Begg’s funnel plots and Egger’s regression test. A total of 1863 patients from ten eligible studies were analyzed. The results showed that PD-L1 expression is associated with poor overall survival in clear cell RCC (ccRCC) (HR = 2.76, 95%CI: 2.25–3.38,I2= 14.4%,P< 0.001) and non-clear cell RCC (non-ccRCC) (HR = 2.77, 95%CI: 1.62–4.72,I2= 28.8%,P< 0.001). In addition, PD-L1 expression was found to be significantly associated with primary tumor stage (OR = 1.76, 95%CI: 1.39–2.23;I2= 56.3%), regional lymph node involvement (OR = 2.10, 95%CI: 1.48–2.98;I2= 14.9%), distant metastases (OR = 2.69, 95%CI: 2.05–3.54;I2= 0.0%), nuclear grade (OR = 1.72, 95%CI: 1.32–2.23;I2= 79.4%) and histologic tumor necrosis (OR = 2.25, 95%CI: 1.59–3.18;I2= 66.1%) in patients with RCC. The outcome stability was confirmed by sensitivity analysis. Both the Begg’s funnel plot test (P= 0.276) and the Egger’s (P= 0.388) verified that there was no publication bias within the included studies. This study suggests that PD-L1 expression is correlated with poor prognosis and advanced clinicopathological features in RCC patients.