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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

Subgroup analysis of programmed cell death 1 ligand 1 (PD-L1) positive versus PD-L1 negative on tumor cells of gastrointestinal tract cancer patients in terms of overall survival.Note: Weights are from random-effects analysis.Abbreviations: CI, confidence interval; HR, hazard ratio; IHC, immunohistochemistry.
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f4-ott-8-2617: Subgroup analysis of programmed cell death 1 ligand 1 (PD-L1) positive versus PD-L1 negative on tumor cells of gastrointestinal tract cancer patients in terms of overall survival.Note: Weights are from random-effects analysis.Abbreviations: CI, confidence interval; HR, hazard ratio; IHC, immunohistochemistry.

Mentions: The H-score evaluation method showed inferior survival in the PD-L1-positive group if we took <50 as the cutoff value (HR 1.75, 95% CI 1.33–2.31, P<0.001). The results were similar when using >50 as the cut-off value (HR 1.79, 95% CI 0.69–4.62, P=0.231). However, an only slightly numerical adverse prognostic effect of PD-L1-positive expression was presented if 10% was taken as the cut-off value using the percentage method (HR 1.05, 95% CI 0.42–2.61, P=0.919) (Figure 4). Additionally, when stratifying studies according to tumor type, we observed that meta-analysis presented significant poorer OS in the PD-L1-positive group of patients with esophageal cancer (HR 2.56, 95% CI 1.55–4.21, P<0.001). Similar numerical survival benefits were found in the PD-L1 negative groups of patients with gastric cancer (HR 1.42, 95% CI 0.84–2.41, P=0.194) and colorectal carcinoma (HR 1.49, 95% CI 0.74–3.00, P=0.260) (Figure 4). Funnel plots with Begg’s test are shown in Figure S1.


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)

Subgroup analysis of programmed cell death 1 ligand 1 (PD-L1) positive versus PD-L1 negative on tumor cells of gastrointestinal tract cancer patients in terms of overall survival.Note: Weights are from random-effects analysis.Abbreviations: CI, confidence interval; HR, hazard ratio; IHC, immunohistochemistry.
© Copyright Policy
Related In: Results  -  Collection

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

f4-ott-8-2617: Subgroup analysis of programmed cell death 1 ligand 1 (PD-L1) positive versus PD-L1 negative on tumor cells of gastrointestinal tract cancer patients in terms of overall survival.Note: Weights are from random-effects analysis.Abbreviations: CI, confidence interval; HR, hazard ratio; IHC, immunohistochemistry.
Mentions: The H-score evaluation method showed inferior survival in the PD-L1-positive group if we took <50 as the cutoff value (HR 1.75, 95% CI 1.33–2.31, P<0.001). The results were similar when using >50 as the cut-off value (HR 1.79, 95% CI 0.69–4.62, P=0.231). However, an only slightly numerical adverse prognostic effect of PD-L1-positive expression was presented if 10% was taken as the cut-off value using the percentage method (HR 1.05, 95% CI 0.42–2.61, P=0.919) (Figure 4). Additionally, when stratifying studies according to tumor type, we observed that meta-analysis presented significant poorer OS in the PD-L1-positive group of patients with esophageal cancer (HR 2.56, 95% CI 1.55–4.21, P<0.001). Similar numerical survival benefits were found in the PD-L1 negative groups of patients with gastric cancer (HR 1.42, 95% CI 0.84–2.41, P=0.194) and colorectal carcinoma (HR 1.49, 95% CI 0.74–3.00, P=0.260) (Figure 4). Funnel plots with Begg’s test are shown in Figure S1.

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