Abstract
BackgroundProgrammed cell death ligand 1 (PD-L1) expression has been shown to associate with poor prognosis in a variety of solid tumors. However, the prognostic value of PD-L1 expression in cervical cancer is still controversial. Therefore, we carried a meta-analysis to investigate the prognostic and clinicopathological impact of PD-L1 in cervical cancer.MethodsA comprehensive literature search in was performed in PubMed, Embase, Web of Science, and Cochrane Library. The correlation between PD-L1 expression and overall survival (OS), progression-free survival (PFS), and clinicopathological features was analyzed by hazard ratios (HR), odds ratios (OR) and corresponding 95% confidence intervals (CI).ResultsSeven studies with 783 patients were included in this meta-analysis. The combined HR and 95% CI of OS was 2.52 (1.09–5.83), p = 0.031. The pooled results for PFS were HR = 2.07, 95% CI = 0.52–8.23, p = 0.302. The results of subgroup analysis showed that PD-L1 was a significant prognostic factor of poor OS in Asian patients (HR = 4.77, 95% CI = 3.02–7.54, p < 0.001) and of poor PFS in Asian patients (HR = 4.78, 95% CI = 1.77–12.91, p = 0.002). However, the pooled results suggested that PD-L1 was not significantly correlated with lymph node metastasis, tumor size, FIGO stage, depth of invasion, lymph-vascular invasion, or age.ConclusionsThe results of this meta-analysis suggest that PD-L1 overexpression is related to poor OS in patients with cervical cancer and poor PFS in Asian patients with cervical cancer. This study also suggests that PD-L1 is a promising prognostic indicator for cervical cancer.
Highlights
Programmed cell death ligand 1 (PD-L1) expression has been shown to associate with poor prognosis in a variety of solid tumors
Inclusion and exclusion criteria Qualified studies need to meet the following inclusion criteria: [1] all patients were diagnosed as cervical cancer by pathological findings; [2] immunohistochemistry (IHC) was used to detect PD-L1 expression in tissues; [3] the relationship between PD-L1 expression and overall survival (OS) and/or progression-free survival (PFS) were provided or sufficient information was provided to estimate the hazard ratio (HR) with Tierney’s method [17]; [4] number of patients was more than 20; [5] the expression of PD-L1 was categorized into high and low groups; [6] English or Chinese articles
Three studies were conducted in China [21,22,23], and one in USA [12], Canada [13], Korea [14], and Japan [15], respectively
Summary
Programmed cell death ligand 1 (PD-L1) expression has been shown to associate with poor prognosis in a variety of solid tumors. The prognostic value of PD-L1 expression in cervical cancer is still controversial. We carried a meta-analysis to investigate the prognostic and clinicopathological impact of PD-L1 in cervical cancer. Cancer cells and infiltrating immune cells express PD-L1, which binds to PD-1 on T cells and suppress the proliferative and effector responses of T cells [5, 6]. The prognostic value of PD-L1 in cervical cancer is still conflicting [12,13,14,15]. We collected eligible data and conducted a meta-analysis to reveal the prognostic and clinical significance of PD-L1 in cervical cancer
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