Association between programmed cell death ligand 1 expression and thyroid cancer: A meta-analysis. Issue 14 (9th April 2021)

• Record Type: Journal Article
• Authors: Wan, Baoyu; Deng, Pengyi; Dai, Wenli; Wang, Peng; Dong, Zhizhi; Yang, Chaojun; Tian, Jinling; Hu, Tao; Yan, Kai
• Other Names: Abid. Hussein section editor.
• Is Part Of: Medicine. Volume 100:Issue 14(2021)
• Publication Date: 2021-04-09
• Subjects: clinicopathological features -- disease-free survival -- meta-analysis -- overall survival -- programmed cell death ligand 1 -- prognosis -- thyroid cancer; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000025315
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract: Background: Programmed cell death ligand 1 (PD-L1), which is highly expressed in a variety of malignant tumors, is closely related to clinicopathological features and prognosis. However, there are few studies on the potential effects of PD-L1 on thyroid carcinoma, the incidence of which has shown an upward trend worldwide. This study aimed to explore the association between PD-L1 expression and clinicopathological features and prognosis of thyroid cancer. Methods: An elaborate retrieval was performed using Medline, PubMed, Cochrane Library, EMBASE, Web of Science, WanFang databases, and China National Knowledge Infrastructure to determine the association between PD-L1 expression and disease-free survival (DFS), overall survival (OS), and clinicopathological features in patients with thyroid cancer. Study selection, data extraction, risk assessment, and data synthesis were performed independently by 2 reviewers. In this meta-analysis, RevMan 5.3 and Stata 15.1 were used for bias risk assessment and data synthesis. Results: After a detailed search, 2546 cases reported in 13 articles were included in this meta-analysis. The outcomes revealed that high expression of PD-L1 in patients with thyroid cancer was associated with poor DFS (hazard ratio [HR] = 3.37, 95% confidence interval [CI] 2.54–4.48, P < .00001) and OS (HR = 2.52, 95% CI: 1.20–5.32, P = .01). High PD-L1 expression was associated with tumor size ≥2 cm, tumor recurrence, extrathyroidal extension, concurrent thyroiditis, unifocal tumor, and absence of psammoma body ( P < .05). Subgroup analysis showed that positive expression of PD-L1 was related to poor prognosis for DFS of non-medullary thyroid carcinoma, and the overexpression of PD-L1 in differentiated thyroid carcinoma (DTC) was related to tumor recurrence, concurrent thyroiditis, extrathyroidal extension, unifocal DTC, late stage DTC, and BRAF V600E mutation in DTC. Conclusion: PD-L1 is a significant predictor of prognosis and malignancy of thyroid cancer (especially DTC), and PD-L1 inhibitors may be a promising therapeutic option for refractory thyroid cancer in the future.