作者：陈丽娜，杨伟忠，孔雨曦

单位：

543002 广西壮族自治区梧州市，梧州市红十字会医院呼吸内科；通信作者：陈丽娜，E-mail：chenlina236@163.com

Units：

Department of Respiratory Medicine，Red Cross Hospital of Wuzhou，Wuzhou 543002，China；Corresponding author：CHEN Lina，E-mail：chenlina236@163.com

关键词：

肺癌；程序性死亡配体 1；临床病理特征；预后；Meta 分析

Keywords：

Lung cancer；PD-L1；Clinicopathological features；Prognosis；Meta-analysis

CLC：

R 734.2

DOI：

DOI：10.3969/j.issn.1008-5971.2020.03.006

Funds：

基金项目：梧州市科学研究与技术开发计划项目（201702005）

摘要：

目的　评价程序性死亡配体 1（PD-L1）与肺癌患者临床病理特征及预后的关系。方法　计算机检索PubMed、Web of Science，the Cochrane Library、中国生物医学文献数据库（CBM）、中国知网（CNKI）、万方数据知识服务平台及维普网等数据库，检索时间自数据库建立至 2019 年 6 月，筛选有关 PD-L1 与肺癌患者临床病理特征及预后关系的对照研究。采用 RevMan 5.3 统计学软件进行 Meta 分析，比较肺癌组织 / 细胞与正常组织 / 细胞中 PD-L1阳性率，有无淋巴结转移及不同病理类型、不同 TNM 分期患者肺癌组织 / 细胞 PD-L1 阳性率，并比较 PD-L1 阳性 /阴性患者生存率。结果　最终纳入 9 篇文献，包含 1 863 例患者。Meta 分析结果显示，肺癌组织 / 细胞 PD-L1 阳性率高于正常组织 / 细胞〔OR=13.91，95%CI（3.62，53.38）〕，有淋巴结转移的患者肺癌组织 / 细胞 PD-L1 阳性率高于无淋巴结转移的患者〔OR=2.73，95%CI（1.59，4.66）〕，鳞癌患者肺癌组织 / 细胞中 PD-L1 阳性率高于腺癌患者〔OR=0.70，95%CI（0.50，0.98）〕，TNM 分期Ⅲ + Ⅳ期患者肺癌组织 / 细胞 PD-L1 阳性率高于 TNM 分期Ⅰ + Ⅱ期患者〔OR=2.24，95%CI（1.79，2.81）〕（P<0.05）；PD-L1 阳性、阴性患者生存率比较，差异无统计学意义〔HR=0.74，95%CI（0.39，1.42），P=0.37〕。Egger's 检验结果显示，报道 PD-L1 阳性、阴性患者生存率的文献无发表偏倚。结论　现有文献证据表明，PD-L1 与肺癌患者淋巴结转移、病理类型、TNM 分期关系密切，但其与肺癌患者预后无明显相关性。

Abstract：

Objective　To evaluate the relations of PD-L1 to clinicopathologic feature and prognosis in patients withlung cancer. Methods　Computer was used to search databases（such as PubMed，Web of Science，the Cochrane Library，CMB，CNKI，Wanfang Data and VIP）to screen control studies about relations of PD-L1 to clinicopathologic feature andprognosis in patients with lung cancer from the construction of database to June 2019. RevMan 5.3 statistics software was used tocomplete this Meta-analysis，positive rate of PD-L1 was compared between lung cancer tissues/cells and normal tissues/cells，meanwhile positive rate of PD-L1 in lung cancer tissues/cells was compared in patients with lymphatic metastasis or not，withdifferent pathological types and TNM stages，moreover survival rate was compared between patients with positive and negativeexpression of PD-L1. Results　A total of 9 literatures were enrolled eventually，including 1，863 cases. Meta-analysis resultsshowed that，positive rate of PD-L1 in lung cancer tissues/cells was statistically significantly higher than that in normal tissues/cells〔OR=13.91，95%CI（3.62，53.38）〕，positive rate of PD-L1 in lung cancer tissues/cells in patients with lymphaticmetastasis was statistically significantly higher than that in patients without lymphatic metastasis〔OR=2.73，95%CI（1.59，4.66）〕，positive rate of PD-L1 in lung cancer tissues/cells in patients with squamous carcinoma was statistically significantlyhigher than that in patients with adenocarcinoma〔OR=0.70，95%CI（0.50，0.98）〕，positive rate of PD-L1 in lung cancertissues/cells in patients with Ⅲ - and Ⅳ -TNM stage was statistically significantly higher than that in patients with Ⅰ - and Ⅱ -TNM stage〔OR=2.24，95%CI（1.79，2.81）〕（P<0.05）；there was no statistically significant difference in survival ratebetween patients with positive and negative expression of PD-L1〔HR=0.74，95%CI（0.39，1.42），P=0.37〕.Egger'stest results showed that，there was no publication bias in literatures reported suvival rate betwen patients with positive andnegative expression of PD-L1. Conclusion　Available literature evidence suggests that，PD-L1 is closely related to lymphaticmetastasis，pathological types and TNM stage in patients with lung cancer，but it is not significantly related to the prognosis.

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