Abstract
BackgroundThe expression of PD-L1 has been reported in ovarian cancer. However, the prognostic role of PD-L1 expression in ovarian carcinoma remained controversial. This study was performed to assess the prognostic value of PD-L1 expression on ovarian cancer.MethodsThe PubMed, Embase, EBSCO, and Cochrane Library databases were searched to identify available publications. The pooled odds ratio (OR) or hazard ratios (HRs: multivariate analysis) with their 95% confidence intervals (95% CIs) were calculated in this analysis. A bioinformatics study based on The Cancer Genome Atlas (TCGA) sequencing and microarray datasets was used to further validate the results of PD-L1 mRNA expression. Kaplan-Meier (KM) survival curves were performed to evaluate the prognostic effect of PD-L1 mRNA expression.ResultsTwelve studies with 1630 ovarian cancers regarding PD-L1 immunohistochemical expression were identified. Meta-analysis showed that PD-L1 protein expression was not associated with tumor grade, clinical stage, lymph node status, tumor histology, overall survival (OS), and progression-free survival (PFS). TCGA data showed no association between PD-L1 mRNA expression and ovarian cancer. Further validation using microarray data suggested that no association between PD-L1 mRNA expression and OS was found in large independent patient cohorts (1310 cases). PD-L1 mRNA expression was significantly linked to worse PFS in 1228 patients with ovarian cancer (227458_at: HR = 1.55, 95% CI = 1.28–1.88, P < 0.001; 223834_at: HR = 1.41, 95% CI = 1.14–1.75, P = 0.0015).ConclusionsMeta-analysis showed that PD-L1 may not be a prognostic factor for ovarian cancer. But a bioinformatics study showed that PD-L1 expression was significantly associated with worse PFS of ovarian cancer. More clinical studies are needed to further validate these findings.
Highlights
Ovarian cancer is the second most common human gynecological malignancy and the most deadly gynecological malignancy among women [1]
The following inclusion criteria for the eligible publications were applied in this systematic review and meta-analysis: 1) the patients had a diagnosis of ovarian cancer based on histopathological examination; 2) cohort studies on the expression of Programmed cell death-ligand 1 (PD-L1) using immunohistochemical (IHC) staining; 3) studies provided data to evaluate the relationship between PD-L1 expression and clinicopathological features of ovarian cancer patients; 4) studies reported sufficient information between PD-L1 expression and the prognosis of ovarian cancer using multivariate analysis, such as overall survival (OS) or progression-free survival (PFS)
The results of meta-analysis demonstrated that PD-L1 expression was not correlated with tumor grade (OR = 1.63, 95% confidence intervals (95% CIs) = 0.90–2.96, P = 0.109, n = three studies with 640 ovarian cancer patients) and clinical stage (OR = 1.14, 95% CI = 0.68–1.91, P = 0.607, n = nine studies with 1326 patients with ovarian cancer) (Fig. 2)
Summary
Ovarian cancer is the second most common human gynecological malignancy and the most deadly gynecological malignancy among women [1]. Wang Journal of Ovarian Research (2019) 12:37 one of the PD-1 ligands and is expressed in on tumor cells and immune cells. PD-L1 expression has been reported to be associated with poor prognosis in many human cancers [11]. Data regarding the prognostic effect of PD-L1 expression in ovarian cancer are limited, and some findings remain controversial. Hamanishi 2007 et al reported that PD-L1 expression was correlated with poor overall survival in ovarian cancer [12]. The expression of PD-L1 has been reported in ovarian cancer. The prognostic role of PD-L1 expression in ovarian carcinoma remained controversial. This study was performed to assess the prognostic value of PD-L1 expression on ovarian cancer
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