The prevalence and clinicopathological features of programmed death-ligand 1 (PD-L1) expression: a pooled analysis of literatures

Ziying Lin, Yutong Xu, Yaxiong Zhang, Qihua He, Jianrong Zhang, Jianxing He, Wenhua Liang, Ziying Lin, Yutong Xu, Yaxiong Zhang, Qihua He, Jianrong Zhang, Jianxing He, Wenhua Liang

Abstract

Background & aims: Programmed death-ligand 1 (PD-L1) has been recognized as a critical and promising target in therapies that direct immune escape of cancers. However, its association with aggressive clinicopathological features in solid tumors remains unclear. We investigated this question by synthesizing published articles.

Methods: Electronic databases were searched for relevant studies. Outcomes of interest included age, gender, tumor size, tumor size, lymph node metastasis and tumor cell differentiation.

Results: A total of 61 studies involving 17 types of malignancies were included. The overall expression rate of PD-L1 was 44.5% (95% CI, 37.5% to 51.6 %). Patients with regional lymph node metastases (OR 1.38; P < 0.01), large size tumor (OR 1.89; P < 0.01) or poor differentiated tumors (OR 1.71; P < 0.01) were associated with higher PD-L1 expression rate. However, no significant association was observed between young and elder patients (OR 1.04; P = 0.58), or male and female patients (OR 1.13; P = 0.06). A numerically higher PD-L1 expression rate was detected in polyclonal antibodies (57.2%) than monoclonal antibodies (39.6%). In addition, the PD-L1 expression rate reported by studies from Asian areas (52.3%) was numerically higher than those from non-Asian areas, namely Caucasians (32.7%).

Conclusions: This meta-analysis indicated that patients with larger tumors, regional lymph node metastases, or poor-differentiated tumors were associated with a higher PD-L1 expression rate; in addition the expression rate of PD-L1 in Asians might be higher than that of Caucasians. This information might be useful in screening candidates for relevant tests and treatments.

Keywords: cancer; clinicopathological features; meta-analysis; programmed death-ligand 1.

Conflict of interest statement

CONFLICTS OF INTEREST

There are no conflicts of interests to declare.

Figures

Figure 1. Flow chart of study selection
Figure 1. Flow chart of study selection
Figure 2. Forest plot for the association…
Figure 2. Forest plot for the association between PD-L1 expression and clinicopathological features
A. age, B. gender. Events refer to cases with PD-L1 positive expression. ORs with corresponding 95 % CIs of individual studies and overall are shown in the forest plot. Abbreviations: OR = odds ratio; CI = confidence interval; LNM= lymph node metastasis; PD-L1= Programmed cell death ligand 1. C. tumor size, D. lymph node metastasis. Events refer to cases with PD-L1 positive expression. ORs with corresponding 95 % CIs of individual studies and overall are shown in the forest plot. Abbreviations: OR = odds ratio; CI = confidence interval; LNM= lymph node metastasis; PD-L1= Programmed cell death ligand 1. E. tumor cell differentiation. Events refer to cases with PD-L1 positive expression. ORs with corresponding 95 % CIs of individual studies and overall are shown in the forest plot. Abbreviations: OR = odds ratio; CI = confidence interval; LNM= lymph node metastasis; PD-L1= Programmed cell death ligand 1.

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Source: PubMed

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