Programmed cell death ligand 1 (PD-L1) expression has been shown to associate with poor prognosis in a variety of solid tumors. However, the prognostic value of PD-L1 expression in cervical cancer is still controversial. Therefore, we performed a meta-analysis to investigate the prognostic and clinicopathological impact of PD-L1 in cervical cancer.
A comprehensive literature search was performed in the PubMed, EMBASE, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), and Wanfang databases. The correlation between PD-L1 expression and overall survival (OS), progression-free survival (PFS), and clinicopathological features was analyzed by hazard ratios (HR), odds ratios (OR) and corresponding 95% confidence intervals (CI).
Seven studies with 783 patients were included in this meta-analysis. The combined HR and 95%CI of OS was 2.52 (1.09-5.83), p = 0.031. The pooled results for PFS were HR = 2.07, 95%CI=0.52-8.23, p = 0.302. The results of subgroup analysis showed that PD-L1 was a significant prognostic factor of poor OS in Asian patients (HR = 4.77, 95%CI=3.02-7.54, p < 0.001) and of poor PFS in Asian patients (HR = 4.78, 95%CI=1.77-12.91, p = 0.002). However, the pooled results suggested that PD-L1 was not significantly correlated with lymph node metastasis, tumour size, FIGO stage, depth of invasion, lymph-vascular invasion, or age.
The results of this meta-analysis suggest that PD-L1 overexpression is related to poor OS in patients with cervical cancer and poor PFS in Asian patients with cervical cancer. This study also suggests that PD-L1 is a promising prognostic indicator for cervical cancer.
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All authors have declared no conflicts of interest.