外泌体程序性细胞死亡配体 l (exoPD-L1) 在预后中的预测作用已得到广泛研究；然而，仍然没有达成共识。对包括 EMBASE、PubMed 和 Web of Science 在内的三个数据库进行了截至 2024 年 1 月 4 日的检索。使用具有 95% 置信区间 (95%CI) 的汇总风险比 (HR) 来识别循环 e​​xoPD-L1 与预后之间的关系。本次统计分析纳入了 15 项研究，涉及 1091 名癌症患者。高exoPD-L1水平与较短的无进展生存期（PFS）（HR = 2.58，95% CI：1.75-3.81）和总生存期（OS）（HR = 1.61，95% CI：1.32-1.98）相关。同时，我们发现免疫治疗早期循环exoPD-L1的动态上调是预后的有利因素（PFS：HR = 0.34，95％CI：0.23-0.51；OS：HR = 0.21，95％CI：0.13 -0.26).循环的exoPD-L1可能是癌症患者的一个有价值的预后指标，监测其在免疫治疗早期的变化可用于预测肿瘤反应和临床结果。此结论可能不适用于浅表肿瘤。© 2024。作者获得 Federación de Sociedades Españolas de Oncología (FESEO) 的独家许可。

The predictive role of exosomal programmed cell death ligand l (exoPD-L1) in prognosis has been studied extensively; however, there is still no consensus.Three databases, including EMBASE, PubMed, and Web of Science, were searched through January 4, 2024. The pooled hazard ratios (HRs) with 95% confidence intervals (95%CIs) were used to identify the relationship between circulating exoPD-L1 and prognosis.15 studies with 1091 patients with cancer were included in this statistical analysis. High exoPD-L1 level was correlated with shorter progression-free survival (PFS) (HR = 2.58, 95% CI: 1.75-3.81) and overall survival (OS) (HR = 1.61, 95% CI: 1.32-1.98). Meanwhile, we found that dynamic upregulation of circulating exoPD-L1 in the early stages of immunotherapy was a favorable factor for prognosis (PFS: HR = 0.34, 95% CI: 0.23-0.51; OS: HR = 0.21, 95% CI: 0.13-0.26).Circulating exoPD-L1 may be a valuable prognostic indicator for patients with cancer and monitoring its changes in the early stages of immunotherapy might be used to predict tumor response and clinical outcome. This conclusion may not apply to superficial tumors.© 2024. The Author(s), under exclusive licence to Federación de Sociedades Españolas de Oncología (FESEO).