| Objective : EBV-associated Gastric Cancer(EBVaGC),with its unique clinicopathological and molecular biological characteristics,has been studied by more and more scholars as an independent subtype of gastric cancer in recent years.This study used a meta-analysis to explore the immunological characteristics of EBVaGC and its value in the immunotherapy and personalized treatment of gastric cancer.Methods:Computer retrieval of PubMed database,EMBASE database and Web of Science database was performed for meta-analysis.Data extraction included the name of the first author of the included literature,year of publication,country,number of cases,etc.Relevant data were extracted,RevMan version 5.3 and Stata version 11.0 were used,and Odds ratio(OR)and 95% Confidence interval(CI)were used for systematic analysis.Q test and quantitative test I test were used to evaluate the heterogeneity between the results of various studies.In this study,when I 2<50% and P>0.1,the heterogeneity of the included literatures was weak,so we adopted the fixed effect model.When I 2>50% and/ or P<0.1,it indicated that there was strong heterogeneity in the included literatures,and random effect model was used for data analysis.The statistical results of the meta-analysis were displayed by forest plot,while the funnel plot was used to show the evaluation results of whether publication bias existed in the included literatures,and the Egger linear regression method and Begg rank correlation method were used to examine and evaluate publication bias Results:A total of 25 articles were included in this study for meta-analysis,and a total of 6636 patients were statistically analyzed.The results showed that the positive expression rate of PD-L1(OR=6.76,95%ci: 3.88-11.78,P < 0.00001)and PD-1(OR=3.66,95%ci: 1.92-6.97,P < 0.00001)in EBVaGC was significantly higher than that in EBVnGC.Microsatellite instability MSI(OR=0.06,95%CI:0.03 ~ 0.12,P < 0.00001)was more common in EBVnGC.The lymphocyte infiltration degree of EBVaGC(OR=8.88,95%CI:3.69 ~ 21.38,P < 0.00001)was significantly higher than that in EBVnGC.The prognosis of patients with EBVaGC receiving conventional treatment(HR=1.27,95%CI: 1.06 ~ 1.44)was worse than that of patients with EBVnGC.Conclusion:This meta-analysis confirmed PD-L1 / PD-1 expression,MSI,CD8 + lymphocytes infiltrating tumor related with EBVaGC,the relationship between gastric cancer may have the function of the EBVaGC prognosis,predicting markers in immune checkpoint group of further research,designed for patients with gastric cancer is more accurate and individualized clinical immune treatment plan to give evidence. |
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