Clinicopathological and prognostic significance of PD-L1 expression in colorectal cancer: a meta-analysis
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ORIGINAL ARTICLE
Clinicopathological and prognostic significance of PD-L1 expression in colorectal cancer: a meta-analysis Shuxia Wang 1 & Bo Yuan 2 & Yun Wang 1 & Mingyang Li 1 & Xibo Liu 1 & Jing Cao 1 & Changtian Li 2 & Jihong Hu 3 Accepted: 26 August 2020 # The Author(s) 2020
Abstract Purpose To systematically evaluate the correlation between PD-L1 expression and clinicopathological features and prognosis of colorectal cancer (CRC). Methods Seven databases (PubMed, Cochrane Library, EMBASE, Web of Science, CBM, Wanfang, and CNKI) were searched through May 2020. Risk of bias and quality of evidence were assessed by using the Newcastle–Ottawa scale (NOS), and metaanalysis was carried out by using the Review Manager 5.3 software on the studies with the quality evaluation scores ≥ 6. Metaregression analysis was used to determine the independent role of PD-L1 expression on CRC prognosis after adjusting clinicopathological features and treatment methods. Results A total of 8823 CRC patients in 32 eligible studies. PD-L1 expression was correlated with lymphatic metastasis (yes/no; OR = 1.24, 95% CI (1.11, 1.38)), diameter of tumor (≥ 5 cm/< 5 cm; OR = 1.34, 95% CI (1.06, 1.70)), differentiation (high– middle/low; OR = 0.68, 95% CI (0.53, 0.87)), and vascular invasion (yes/no; OR = 0.80, 95% CI (0.69, 0.92)). PD-L1 expression shortened the overall survival (hazard ratio (HR) = 1.93, 95% CI (1.66, 2.25)), disease-free survival (HR = 1.76, 95% CI (1.50, 2.07)), and progression-free survival (HR = 1.93, 95% CI (1.55, 2.41)). Meta-regression showed that PD-L1 expression played a significant role on poor CRC OS (HR = 1.95, 95% CI (1.92, 3.98)) and disease-free survival (HR = 2.14, 95% CI (0.73, 4.52)). Conclusion PD-L1 expression independently predicted a poor prognosis of CRC. Keywords Programmed death ligand-1 (PD-L1) . Colorectal cancer (CRC) . Prognosis . Clinicopathological features . Meta-analysis
Introduction Colorectal cancer (CRC) is one of the most common malignant tumors of the digestive system all around the world [1]. Its incidence and mortality rate ranked third and
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00384-020-03734-4) contains supplementary material, which is available to authorized users. * Jihong Hu [email protected] 1
Public Health School, Gansu University of Chinese Medicine, Lanzhou 730000, China
2
Basic Medical School, Gansu University of Chinese Medicine, Lanzhou 730000, China
3
Center of Research and Experiment, Gansu University of Chinese Medicine, Lanzhou 730000, China
second in the world, respectively [2]. In 2018, both new cases and deaths were close to 30% of the total number of CRC cases in the world [3, 4]. China’s cancer statistics indicated that the incidence and mortality of CRC ranked fifth among all malignant tumors in China, bringing about 380,000 new cases and 190,000 deaths annually [5]. Furthermore, most patients have already been in the severe stage when they were seeking the medical examination [6, 7]. Thus, it
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