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Programmed Death-Ligand 1 (PD-L1) Is a Potential Biomarker of Disease-Free Survival in Papillary Thyroid Carcinoma: a Systematic Review and Meta-Analysis of PD-L1 Immunoexpression in Follicular Epithelial Derived Thyroid Carcinoma

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Abstract

The expression of programmed death-ligand 1 (PD-L1) is an established prerequisite for the administration of checkpoint inhibitor therapy and is of prognostic value in several cancer types. Data concerning the potential effect of PD-L1 on the prognosis of thyroid carcinoma are limited. Therefore, this study aimed to provide a systematic review of the published data on this topic. The literature was reviewed to gather and quantify evidence on the prognostic role of PD-L1 in follicular epithelial derived thyroid carcinomas and determine its association with clinicopathological parameters. A meta-analysis was performed using the DerSimonian-Laird random-effects model. The quality of studies was evaluated with the Newcastle-Ottawa Scale and a modified GRADE approach used to rate the quality of evidence. Out of 445 papers, 18 were included and 15 provided adequate data for meta-analysis. The quality of evidence ranged from low to high. PD-L1 expression was significantly associated with a reduced disease-free survival (DFS) (RR 1.63, CI 1.04–2.56, p = 0.03, I2 68%, τ2 0.19 and HR 1.90, CI 1.33–2.70, p< 0.001, I2 0%, τ2 0.00); however, no association was found with the overall survival (OS). Furthermore, a significant association was found with respect to underlying chronic lymphocytic thyroiditis and BRAFV600E mutation status in papillary thyroid carcinomas. In the subgroup analysis, the association of PD-L1 and DFS remained strong in papillary thyroid carcinoma when compared with dedifferentiated thyroid carcinomas (anaplastic and poorly differentiated thyroid carcinomas) that failed to demonstrate a significant association with respect to PD-L1. These findings underscore the role of PD-L1 immunohistochemistry as a potential prognostic biomarker of disease recurrence in patients with papillary thyroid carcinoma.

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Authors and Affiliations

  1. Department of Pathology and Diagnostics, University and Hospital Trust of Verona, P.le Stefani n. 1, 37126, Verona, Italy

    Ilaria Girolami, Matteo Brunelli, Stefano Marletta, Chiara Colato & Albino Eccher

  2. Department of Pathology, UPMC Shadyside Hospital, University of Pittsburgh, Pittsburgh, PA, USA

    Liron Pantanowitz

  3. Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada

    Ozgur Mete

  4. Clinic for Nuclear Medicine and Competence Centre for Thyroid Disease, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland

    Pierpaolo Trimboli

  5. Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland

    Pierpaolo Trimboli

  6. Section of Pathology, University Hospital Campus Bio Medico, Rome, Italy

    Anna Crescenzi

  7. Synlab Swiss SA, Pathology, Lausanne, Switzerland

    Massimo Bongiovanni

  8. Pathology Unit, Santa Chiara Hospital, Trento, Italy

    Mattia Barbareschi

Authors
  1. Ilaria Girolami
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  2. Liron Pantanowitz
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  3. Ozgur Mete
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  4. Matteo Brunelli
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  5. Stefano Marletta
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  6. Chiara Colato
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  7. Pierpaolo Trimboli
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  8. Anna Crescenzi
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  9. Massimo Bongiovanni
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  10. Mattia Barbareschi
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  11. Albino Eccher
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Contributions

IG—study design, literature search, data extraction, data analysis, manuscript preparation, review, and approval of final manuscript. LP—study design, manuscript preparation, and review and approval of final manuscript. OM—manuscript preparation, and review and approval of final manuscript. MBr—review and approval of final manuscript. SM—literature search, data extraction, and review and approval of final manuscript. CC—review and approval of final manuscript. PT—manuscript preparation, review, and approval of final manuscript. AC—review and approval of final manuscript. MBo—review and approval of final manuscript. MBa—review and approval of final manuscript. AE—study design, data analysis, manuscript preparation, review and approval of final manuscript, and project supervision.

Corresponding author

Correspondence to Albino Eccher.

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The authors declare that they have no conflict of interest.

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No ethical issues are raised by systematic reviews.

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Girolami, I., Pantanowitz, L., Mete, O. et al. Programmed Death-Ligand 1 (PD-L1) Is a Potential Biomarker of Disease-Free Survival in Papillary Thyroid Carcinoma: a Systematic Review and Meta-Analysis of PD-L1 Immunoexpression in Follicular Epithelial Derived Thyroid Carcinoma. Endocr Pathol 31, 291–300 (2020). https://doi.org/10.1007/s12022-020-09630-5

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