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The expression status and prognostic significance of programmed cell death 1 ligand 1 in gastrointestinal tract cancer: a systematic review and meta-analysis.

Huang B, Chen L, Bao C, Sun C, Li J, Wang L, Zhang X - Onco Targets Ther (2015)

Bottom Line: We found the PD-L1-positive expression rate was 0.495 (95% CI 0.415-0.576) if 10% was taken as the cut-off value.Additionally, PD-L1-positive gastrointestinal tract cancer patients were associated with significantly poorer OS when compared to negative ones (HR 1.61, 95% CI 1.10-2.35, P=0.014).Subgroup analysis presented similar significant results in patients with esophageal cancer (HR 2.56, 95% CI 1.55-4.21, P<0.001).

View Article: PubMed Central - PubMed

Affiliation: Department of Laboratory Medicine, Yantai Yuhuangding Hospital, Yantai, People's Republic of China.

ABSTRACT

Background: Programmed cell death 1 ligand 1 (PD-L1) expression has been observed in various malignancies. However, the association between PD-L1 expression and the survival of patients with gastrointestinal tract cancer remains controversial. Besides, the rate of PD-L1 positivity on tumor cells of digestive tract cancer is not clear. Thus, we performed a meta-analysis by incorporating all available evidence to evaluate the rate of PD-L1 positivity and the overall survival (OS) according to PD-L1 status in patients with gastrointestinal tract cancer.

Methods: Electronic databases were searched for eligible literature. Hazard ratios (HRs) for OS with 95% confidence intervals (CIs) according to the expression status of PD-L1 evaluated by immunohistochemistry were extracted. The outcomes were synthesized based on a random-effects model.

Results: Fifteen studies (only nine reported OS) that involved 2,993 gastrointestinal tract cancer patients stratified by PD-L1 status were eligible for inclusion in our study. We found the PD-L1-positive expression rate was 0.495 (95% CI 0.415-0.576) if 10% was taken as the cut-off value. When the H-score method was used to evaluate PD-L1 expression, it showed that the PD-L1 positive rate was 0.639 (95% CI 0.490-0.765) if the cut-off value was <50, which was higher than when using >50 as the cut-off point (0.449, 95% CI 0.417-0.483). Additionally, PD-L1-positive gastrointestinal tract cancer patients were associated with significantly poorer OS when compared to negative ones (HR 1.61, 95% CI 1.10-2.35, P=0.014). Subgroup analysis presented similar significant results in patients with esophageal cancer (HR 2.56, 95% CI 1.55-4.21, P<0.001).

Conclusion: The positive expression rate of PD-L1 was nearly 50% no matter which method for immunohistochemistry evaluation we chose. Additionally, positive PD-L1 expression status in tumor cells is a risk factor for prognosis of gastrointestinal tract cancer, especially esophageal cancer.

No MeSH data available.


Related in: MedlinePlus

Flow chart of study selection.Abbreviation: PD-L1, programmed cell death 1 ligand 1.
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f1-ott-8-2617: Flow chart of study selection.Abbreviation: PD-L1, programmed cell death 1 ligand 1.

Mentions: In total, 574 records were identified according to the search strategy. Finally, we enrolled 15 studies15–29 that involved 2,993 gastrointestinal tract cancer patients (1,461/1,532 cases for PD-L1 positive/negative) with available PD-L1 expression data stratified by PD-L1 status. Nine of the studies16–19,21,23,26–28 reported HRs for OS as a clinical outcome. Figure 1 summarizes the flow chart of study selection. Our study covered three major types of gastrointestinal tract cancer, esophageal cancer, gastric cancer, and colorectal carcinoma. The H-score was one of the most common methods used to evaluate the expression of PD-L1 in the tumor cells among the included articles, as well as the percentage of positively stained cells. The characteristics of the enrolled studies are shown in Table 1.


The expression status and prognostic significance of programmed cell death 1 ligand 1 in gastrointestinal tract cancer: a systematic review and meta-analysis.

Huang B, Chen L, Bao C, Sun C, Li J, Wang L, Zhang X - Onco Targets Ther (2015)

Flow chart of study selection.Abbreviation: PD-L1, programmed cell death 1 ligand 1.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4592050&req=5

f1-ott-8-2617: Flow chart of study selection.Abbreviation: PD-L1, programmed cell death 1 ligand 1.
Mentions: In total, 574 records were identified according to the search strategy. Finally, we enrolled 15 studies15–29 that involved 2,993 gastrointestinal tract cancer patients (1,461/1,532 cases for PD-L1 positive/negative) with available PD-L1 expression data stratified by PD-L1 status. Nine of the studies16–19,21,23,26–28 reported HRs for OS as a clinical outcome. Figure 1 summarizes the flow chart of study selection. Our study covered three major types of gastrointestinal tract cancer, esophageal cancer, gastric cancer, and colorectal carcinoma. The H-score was one of the most common methods used to evaluate the expression of PD-L1 in the tumor cells among the included articles, as well as the percentage of positively stained cells. The characteristics of the enrolled studies are shown in Table 1.

Bottom Line: We found the PD-L1-positive expression rate was 0.495 (95% CI 0.415-0.576) if 10% was taken as the cut-off value.Additionally, PD-L1-positive gastrointestinal tract cancer patients were associated with significantly poorer OS when compared to negative ones (HR 1.61, 95% CI 1.10-2.35, P=0.014).Subgroup analysis presented similar significant results in patients with esophageal cancer (HR 2.56, 95% CI 1.55-4.21, P<0.001).

View Article: PubMed Central - PubMed

Affiliation: Department of Laboratory Medicine, Yantai Yuhuangding Hospital, Yantai, People's Republic of China.

ABSTRACT

Background: Programmed cell death 1 ligand 1 (PD-L1) expression has been observed in various malignancies. However, the association between PD-L1 expression and the survival of patients with gastrointestinal tract cancer remains controversial. Besides, the rate of PD-L1 positivity on tumor cells of digestive tract cancer is not clear. Thus, we performed a meta-analysis by incorporating all available evidence to evaluate the rate of PD-L1 positivity and the overall survival (OS) according to PD-L1 status in patients with gastrointestinal tract cancer.

Methods: Electronic databases were searched for eligible literature. Hazard ratios (HRs) for OS with 95% confidence intervals (CIs) according to the expression status of PD-L1 evaluated by immunohistochemistry were extracted. The outcomes were synthesized based on a random-effects model.

Results: Fifteen studies (only nine reported OS) that involved 2,993 gastrointestinal tract cancer patients stratified by PD-L1 status were eligible for inclusion in our study. We found the PD-L1-positive expression rate was 0.495 (95% CI 0.415-0.576) if 10% was taken as the cut-off value. When the H-score method was used to evaluate PD-L1 expression, it showed that the PD-L1 positive rate was 0.639 (95% CI 0.490-0.765) if the cut-off value was <50, which was higher than when using >50 as the cut-off point (0.449, 95% CI 0.417-0.483). Additionally, PD-L1-positive gastrointestinal tract cancer patients were associated with significantly poorer OS when compared to negative ones (HR 1.61, 95% CI 1.10-2.35, P=0.014). Subgroup analysis presented similar significant results in patients with esophageal cancer (HR 2.56, 95% CI 1.55-4.21, P<0.001).

Conclusion: The positive expression rate of PD-L1 was nearly 50% no matter which method for immunohistochemistry evaluation we chose. Additionally, positive PD-L1 expression status in tumor cells is a risk factor for prognosis of gastrointestinal tract cancer, especially esophageal cancer.

No MeSH data available.


Related in: MedlinePlus