Clinical Research Papers:
High PD-L1 expression was associated with poor prognosis in 870 Chinese patients with breast cancer
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Tao Qin1,*, Yin-duo Zeng1,2,*, Ge Qin1,*, Fei Xu1,*, Jia-bin Lu1, Wen-feng Fang1, Cong Xue1, Jian-hua Zhan1, Xin-ke Zhang1, Qiu-fan Zheng1, Rou-jun Peng1, Zhong-yu Yuan1, Li Zhang1 and Shu-sen Wang1
1 Sun Yat-sen University Cancer Center, The State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, P. R. China
2 Sun Yat-sen University Sun Yat-sen Memorial Hospital, Guangzhou, Guangdong, P. R. China
* These authors have contributed equally to this work
Shu-sen Wang, email:
Li Zhang, email:
Zhong-yu Yuan, email:
Keywords: PD-L1, breast cancer, ER, PR, prognosis, nomogram
Received: July 07, 2015 Accepted: August 22, 2015 Published: September 10, 2015
Background: To investigate the role of PD-L1 expression in tumor recurrence and metastasis in Chinese patients with breast cancer.
Methods: Suitable tissue samples were available from 870 patients with breast cancer. Paraffin-embedded tumor sections were stained with PD-L1 antibody. The correlations between PD-L1 expression and clinical characteristics, ER/PR/HER2 status and survival parameters were analyzed. Kaplan-Meier and univariate Cox proportional hazards model analyses were used to compare the survival of patients with high PD-L1 expression and patients with no PD-L1 expression.
Results: The median follow-up time was 98 months(range, 17–265 months).The positive rate of PD-L1 expression in breast cancer was 21.7% (189/870). PD-L1 high expression was inversely associated with larger tumor size, higher tumor grade, more positive lymph node number, as well as negative ER and PR status. PD-L1 expression was particularly higher in TNBC compared with non-TNBC, although no statistical significance was observed. Nomogram logistic regression results based on clinical and pathological features showed that the following factors were more likely associated with high PD-L1 expression: patient age younger than 35 years, larger tumor size, lymphovascular invasion and advanced stage. Our data indicated that patients with high PD-L1 expression had poor DFS, DMFS and overall survival compared with those with no PD-L1 expression. Univariate Cox proportional hazards model analysis showed that PD-L1 was an independent prognostic factor for tumor prognosis.
Conclusions: PD-L1 expression is an important indicator of unfavorable prognosis in breast cancer patients.
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