Table_1_Prognostic value of programmed cell death ligand 1 expression in patients with intrahepatic cholangiocarcinoma: a meta-analysis.docx

BackgroundProgrammed cell death ligand 1 (PD-L1) is highly expressed in intrahepatic cholangiocarcinoma (ICC) tissues. But there is still a dispute over the prognostic value of PD-L1 in patients with ICC. This study aimed to evaluate the prognostic value of PD-L1 expression in patients with ICC.
MethodsWe performed a meta-analysis based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Guidelines. We searched the literature from PubMed, Embase, Web of Science, and the Cochrane Library up to December 5, 2022. Hazard ratios (HR) and their 95% confidence intervals (95% CI) were calculated to analyze the overall survival (OS), recurrence-free survival (RFS), and time to relapse. The quality of the studies was assessed using the Newcastle-Ottawa scale. Publication bias was assessed using a funnel plot and Egger’s test.
ResultsTen trials with 1944 cases were included in this meta-analysis. The results showed that the low-PD-L1 group had a statistically significant advantage in OS (HR, 1.57; 95% CI, 1.38–1.79, P <0.00001), RFS (HR, 1.62; 95% CI, 1.34–1.97, P <0.00001), and time to relapse (HR, 1.60; 95% CI, 1.25–2.05, P = 0.0002) compared with the high-PD-L1 group. High programmed cell death (PD1)levels, on the other hand, were correlated with poorer OS (HR, 1.96; 95% CI, 1.43–2.70; P <0.0001) and RFS (HR, 1.87; 95% CI, 1.21–2.91; P = 0.005). Multivariate analysis showed that PD-L1 could act as an independent predictor for OS (HR, 1.48; 95% CI, 1.14–1.91; P = 0.003) and RFS (HR, 1.74; 95% CI, 1.22–2.47; P = 0.002), and PD1 acted as an independent predictor for OS (HR, 1.66; 95% CI, 1.15–2.38; P = 0.006).
ConclusionThis meta-analysis demonstrated that high PD-L1/PD1 expression is associated with poor survival in ICC. PD-L1/PD1 may be a valuable prognostic and predictive biomarker and potential therapeutic target in ICC.
Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022380093.

背景 程序性死亡受体配体1（Programmed cell death ligand 1, PD-L1）在肝内胆管癌（Intrahepatic Cholangiocarcinoma, ICC）组织中呈高表达，但目前关于PD-L1对ICC患者的预后价值仍存在争议。本研究旨在评估PD-L1表达对ICC患者的预后价值。
方法 本研究基于《系统评价与Meta分析首选报告条目（PRISMA）指南》开展Meta分析。我们检索了截至2022年12月5日的PubMed、Embase、Web of Science及Cochrane图书馆数据库中的相关文献。通过计算风险比（Hazard ratio, HR）及其95%置信区间（95% confidence interval, 95% CI），分析总生存期（Overall survival, OS）、无复发生存期（Recurrence-free survival, RFS）及复发时间。采用纽卡斯尔-渥太华量表（Newcastle-Ottawa scale）评估纳入研究的质量，使用漏斗图与Egger检验评估发表偏倚。
结果 本Meta分析共纳入10项研究，涉及1944例患者。结果显示，与PD-L1高表达组相比，PD-L1低表达组患者的OS（HR=1.57；95%CI=1.38~1.79，P<0.00001）、RFS（HR=1.62；95%CI=1.34~1.97，P<0.00001）及复发时间（HR=1.60；95%CI=1.25~2.05，P=0.0002）均具有统计学优势。另一方面，程序性死亡受体1（Programmed cell death 1, PD-1）高表达与较差的OS（HR=1.96；95%CI=1.43~2.70；P<0.0001）和RFS（HR=1.87；95%CI=1.21~2.91；P=0.005）相关。多因素分析显示，PD-L1可作为OS（HR=1.48；95%CI=1.14~1.91；P=0.003）与RFS（HR=1.74；95%CI=1.22~2.47；P=0.002）的独立预测因子，PD-1则可作为OS的独立预测因子（HR=1.66；95%CI=1.15~2.38；P=0.006）。
结论 本Meta分析证实，PD-L1/PD-1高表达与ICC患者不良生存结局相关。PD-L1/PD-1有望成为ICC患者具有临床价值的预后与预测生物标志物，以及潜在的治疗靶点。本系统评价的注册信息：https://www.crd.york.ac.uk/PROSPERO/，注册号为CRD42022380093。