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Breast Cancer Research and Treatment

, Volume 178, Issue 1, pp 17–33 | Cite as

Prognostic and clinicopathological value of PD-L1 expression in primary breast cancer: a meta-analysis

  • Wenfa Huang
  • Ran Ran
  • Bin Shao
  • Huiping LiEmail author
Review

Abstract

Purpose

To evaluate the association between PD-L1 expression (PD-L1+) and clinicopathological characteristics and effect on prognosis in primary breast cancer (PBC).

Methods

A systematic search of the PubMed, Web of Science, and Embase databases was conducted in November 2018. Studies detecting PD-L1 using immunohistochemistry, and concerning its prognostic or clinicopathological significance in PBC were included. The HR with 95% CI for survival, and the events for clinicopathological features were pooled.

Results

Forty-seven studies were included, with a total of 14,367 PBC patients. PD-L1+ tumor cells (TCs) were associated with ductal carcinomas, large tumor size, histological Grade 3 tumors, high Ki-67, ER and PR negative, and triple-negative breast cancer; and also, related to high tumor-infiltrating lymphocytes (TILs) and PD-1 expression. PD-L1+ TCs were significantly associated with shorter disease-free survival (DFS, HR = 1.43, 95% CI 1.21–1.70, P < 0.0001) and overall survival (OS, HR = 1.58, 95% CI 1.14–2.20, P = 0.006). And the HRs of PD-L1+ TCs on DFS and OS were higher (1.48 and 1.70, respectively) and homogeneous when using whole tissue section, compared with tumor microarrays. However, PD-L1+ TILs related to better DFS (HR = 0.45, 95% CI 0.28–0.73, P = 0.001) and OS (HR = 0.41, 95% CI 0.27–0.63, P < 0.0001).

Conclusion

PD-L1 expression on TCs associates with high-risk clinicopathological parameters and poor prognosis in PBC patients, while PD-L1+ TILs may relate to a better survival. Comprehensive assessment of TCs and TILs is required when evaluating the clinical relevance of PD-L1 expression in future studies.

Keywords

Primary breast cancer PD-L1 Immunohistochemistry Prognosis Meta-analysis 

Notes

Acknowledgements

The authors are pleased to acknowledge the suggestions from Professor Xu Liang and Xiaoran Liu, which are crucial for manuscript revision.

Funding

There were no funding sources for this work.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

Not applicable (no informed consent required).

Supplementary material

10549_2019_5371_MOESM1_ESM.pdf (1.9 mb)
Supplementary material 1 (PDF 1932 kb)
10549_2019_5371_MOESM2_ESM.pdf (83 kb)
Supplementary material 2 (PDF 83 kb)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Breast OncologyPeking University Cancer Hospital and InstituteBeijingChina

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