PD-L1在子宫内膜癌中的表达及其临床意义的meta分析

Meta-analysis of the expression of PD-L1 in endometrial carcinoma and its clinical significance

目的系统评价PD-L1在子宫内膜癌中的表达及其临床意义。方法计算机检索PubMed、Cochrane Library、EMBASE、Web of Science、中国知网、万方和维普等数据库,检索时间为建库至2022年2月。检索子宫内膜癌相关文献,采用STATA16.0软件进行meta分析。结果共纳入26篇文献。meta分析结果显示,PD-L1表达对子宫内膜癌患者无进展生存期(PFS)、总生存期(OS)均无显著影响(P=0.768、0.549)。PD-L1高表达与淋巴血管间隙浸润(LVSI)、国际妇产科联盟(FIGO)分期、浸润深度(≥1/2)、淋巴结转移(LNM)、较高组织学分级显著相关(P<0.05),与病理类型无显著相关性(P>0.05)。进一步的亚组分析显示,在肿瘤细胞、肿瘤浸润免疫细胞中,PD-L1高表达与较晚FIGO分期显著相关(P<0.05)。PD-L1表达对PD-1/PD-L1抑制剂疗效无显著影响(P>0.05)。结论PD-L1高表达与LVSI、较晚FIGO分期、浸润深度(≥1/2)、LNM、较高组织学分级显著相关,但PD-L1表达对子宫内膜癌患者PFS、OS、PD-1/PD-L1抑制剂疗效无显著影响。

Objective To systematically evaluate the expression of programmed cell death-Ligand 1(PD-L1)in endometrial carcinoma and its clinical significance.Methods The PubMed,Cochrane Library,Excerpta Medica Database,Web of Science,China National Knowledge Infrastructure,Wanfang,VIP and other databases were retrieved by computer.The retrieval time was from the establishment of the database to February 2022.The literatures related to endometrial cancer were retrieved,and the meta-analysis was performed using STATA16.0 software.Results A total of 26 articles were included.The results of meta-analysis showed that the expression of PD-L1 had no significant effect on the progression-free survival(PFS)and overall survival(OS)of endometrial cancer patients(P=0.768,0.549).The high expression of PD-L1 was significantly correlated with lymphatic vascular space infiltration(LVSI),federation international of gynecology and obstetrics(FIGO)stage,invasion depth(≥1/2),lymph node metastasis(LNM)and higher histological grade(P<0.05),but not with pathological type(P>0.05).Further subgroup analysis showed that the high expression of PD-L1 in tumor cells and tumor-infiltrating immune cells was significantly correlated with the later FIGO stage(P<0.05).The expression of PD-L1 had no significant effect on the efficacy of PD-1/PD-L1 inhibitors(P>0.05).Conclusion The high expression of PD-L1 is significantly correlated with LVSI,late FIGO stage,depth of invasion(≥1/2),LNM,and higher histological grade,but the expression of PD-L1 has no significant effect on the efficacy of PFS,OS,PD-1/PD-L1 inhibitors in patients with endometrial carcinoma.