The clinicopathological and prognostic significance of PD-L1 expression assessed by immunohistochemistry in lung cancer: a meta-analysis of 50 studies with 11,383 patients
The clinicopathological and prognostic significance of PD-L1 expression assessed by immunohistochemistry in lung cancer: a meta-analysis of 50 studies with 11,383 patients
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DOI：
10.21037/tlcr.2019.08.04
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发表时间：
2019-08-01
影响因子：
4
通讯作者：
Lv, Tangfeng
中科院分区：
文献类型：
--
作者：
Li, Huijuan;Xu, Yangyang;Lv, Tangfeng
背景：我们进行了一项荟萃分析，系统评估肺癌患者程序性死亡配体 1 (PD-L1) 表达与生存之间的关系。方法：检索电子数据库 PubMed、Embase、Cochrane 和 Web of Science 截至 2018 年 1 月 2 日，有关免疫组织化学 (IHC) 检测 PD-L1 表达与肺癌患者预后相关的文章。结果：50 项研究，包括 11,383 项研究2011 年至 2017 年间发表的患者被纳入这项荟萃分析。汇总风险比 (HR) 和 95% 置信区间 (CI) 表明 PD-L1 IHC 表达与较差的总生存期 (OS) 相关（HR = 1.45，95% CI：1.24-1.68）。在根据样本类型、临界值、种族和TNM分期分类的亚组分析中，汇总结果显示，当切除标本检测到PD-L1表达时，PD-L1阳性组的生存率较差（P=0.000），以5%为临界值（P=0.000），患者处于早期（I-III）期（P=0.000），研究的地理背景是在亚洲（P=0.000）。此外，NSCLC（P=0.000）、ADC（P=0.000）、SCC（P=0.353）和LELC（P=0.810）中PDL1高表达患者的OS较短，而SCLC（P=0.000）中无显着差异。合并优势比 (OR) 表明 PD-L1 表达与男性相关 (P
Background: We conducted a meta-analysis to systematically evaluate the relationship between programmed death-ligand 1 (PD-L1) expression and survival in patients with lung cancer.Methods: The electronic databases PubMed, Embase, Cochrane, and Web of Science were searched up to January 2nd, 2018, for articles relating to PD-L1 expression detected by immunohistochemistry (IHC) and lung cancer patient prognosis.Results: Fifty studies including 11,383 patients published between 2011 and 2017 were enrolled in this meta-analysis. The pooled hazard ratios (HRs) and 95% confidence intervals (CIs) suggested that PD-L1 IHC expression was related to poor overall survival (OS) (HR = 1.45, 95% CI: 1.24-1.68). In subgroup analysis categorized according to sample type, cut-off value, ethnicity and TNM stage, the pooled results demonstrated inferior survival in the PD-L1 positive group when the PD-L1 expression was detected by resection specimens (P=0.000), 5% was taken as the cutoff value (P=0.000), the patients were in early stage (I-III) (P=0.000), and the geographic setting of the study was in Asia (P=0.000). Besides, patients with high PDL1 expression had shorter OS in NSCLC (P=0.000), ADC (P=0.000), SCC (P=0.353) and LELC (P=0.810), while no significant difference was observed in SCLC (P=0.000). The pooled odds ratios (ORs) suggested that PD-L1 expression was associated with male (P