The clinicopathological and prognostic significance of PD-L1 expression assessed by immunohistochemistry in lung cancer: a meta-analysis of 50 studies with 11,383 patients.

Lung cancer meta-analysis prognosis programmed cell death ligand 1

Journal

Translational lung cancer research
ISSN: 2218-6751
Titre abrégé: Transl Lung Cancer Res
Pays: China
ID NLM: 101646875

Informations de publication

Date de publication:
Aug 2019
Historique:
entrez: 27 9 2019
pubmed: 27 9 2019
medline: 27 9 2019
Statut: ppublish

Résumé

We conducted a meta-analysis to systematically evaluate the relationship between programmed death-ligand 1 (PD-L1) expression and survival in patients with lung cancer. The electronic databases PubMed, Embase, Cochrane, and Web of Science were searched up to January 2 Fifty studies including 11,383 patients published between 2011 and 2017 were enrolled in this meta-analysis. The pooled hazard ratios (HRs) and 95% confidence intervals (CIs) suggested that PD-L1 IHC expression was related to poor overall survival (OS) (HR =1.45, 95% CI: 1.24-1.68). In subgroup analysis categorized according to sample type, cut-off value, ethnicity and TNM stage, the pooled results demonstrated inferior survival in the PD-L1 positive group when the PD-L1 expression was detected by resection specimens (P=0.000), 5% was taken as the cutoff value (P=0.000), the patients were in early stage (I-III) (P=0.000), and the geographic setting of the study was in Asia (P=0.000). Besides, patients with high PD-L1 expression had shorter OS in NSCLC (P=0.000), ADC (P=0.000), SCC (P=0.353) and LELC (P=0.810), while no significant difference was observed in SCLC (P=0.000). The pooled odds ratios (ORs) suggested that PD-L1 expression was associated with male (P<0.001), smoker (P<0.001), poor tumor differentiation (P=0.014), large tumor size (P=0.132), positive lymph nodal metastasis (P=0.002), PD-L1 expression that is associated with several clinicopathological feactures may serve as a poor prognostic biomarker for patients with lung cancer.

Sections du résumé

BACKGROUND BACKGROUND
We conducted a meta-analysis to systematically evaluate the relationship between programmed death-ligand 1 (PD-L1) expression and survival in patients with lung cancer.
METHODS METHODS
The electronic databases PubMed, Embase, Cochrane, and Web of Science were searched up to January 2
RESULTS RESULTS
Fifty studies including 11,383 patients published between 2011 and 2017 were enrolled in this meta-analysis. The pooled hazard ratios (HRs) and 95% confidence intervals (CIs) suggested that PD-L1 IHC expression was related to poor overall survival (OS) (HR =1.45, 95% CI: 1.24-1.68). In subgroup analysis categorized according to sample type, cut-off value, ethnicity and TNM stage, the pooled results demonstrated inferior survival in the PD-L1 positive group when the PD-L1 expression was detected by resection specimens (P=0.000), 5% was taken as the cutoff value (P=0.000), the patients were in early stage (I-III) (P=0.000), and the geographic setting of the study was in Asia (P=0.000). Besides, patients with high PD-L1 expression had shorter OS in NSCLC (P=0.000), ADC (P=0.000), SCC (P=0.353) and LELC (P=0.810), while no significant difference was observed in SCLC (P=0.000). The pooled odds ratios (ORs) suggested that PD-L1 expression was associated with male (P<0.001), smoker (P<0.001), poor tumor differentiation (P=0.014), large tumor size (P=0.132), positive lymph nodal metastasis (P=0.002),
CONCLUSIONS CONCLUSIONS
PD-L1 expression that is associated with several clinicopathological feactures may serve as a poor prognostic biomarker for patients with lung cancer.

Identifiants

pubmed: 31555517
doi: 10.21037/tlcr.2019.08.04
pii: tlcr-08-04-429
pmc: PMC6749117
doi:

Types de publication

Journal Article

Langues

eng

Pagination

429-449

Commentaires et corrections

Type : CommentIn

Déclaration de conflit d'intérêts

Conflicts of Interest: The authors have no conflicts of interest to declare.

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Auteurs

Huijuan Li (H)

Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China.
Nanjing University Institute of Respiratory Medicine, Nanjing 21000, China.

Yangyang Xu (Y)

Department of Respiratory Medicine, Jinling Hospital, Nanjing Medical University, Nanjing 210002, China.

Bing Wan (B)

Department of Respiratory and Critical Care Medicine, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing 210002, China.

Yong Song (Y)

Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China.
Nanjing University Institute of Respiratory Medicine, Nanjing 21000, China.
Department of Respiratory Medicine, Jinling Hospital, Nanjing Medical University, Nanjing 210002, China.

Ping Zhan (P)

Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China.
Nanjing University Institute of Respiratory Medicine, Nanjing 21000, China.

Yangbo Hu (Y)

Department of Respiratory Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing 210000, China.

Qun Zhang (Q)

Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China.
Nanjing University Institute of Respiratory Medicine, Nanjing 21000, China.

Fang Zhang (F)

Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China.
Nanjing University Institute of Respiratory Medicine, Nanjing 21000, China.

Hongbing Liu (H)

Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China.
Nanjing University Institute of Respiratory Medicine, Nanjing 21000, China.

Tianhong Li (T)

Division of Hematology/Oncology, Department of Internal Medicine, University of California Davis School of Medicine, University of California Davis Comprehensive Cancer Center, Sacramento, California, USA.

Haruhiko Sugimura (H)

Department of Tumor Pathology, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan.

Federico Cappuzzo (F)

AUSL Romagna, Department of Oncology and Hematology, Ravenna, Italy.

Dang Lin (D)

Department of Respiratory and Critical Care Medicine, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou 215001, China.

Tangfeng Lv (T)

Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China.
Nanjing University Institute of Respiratory Medicine, Nanjing 21000, China.

Classifications MeSH