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Review
. 2020 Sep 17;10(9):704.
doi: 10.3390/diagnostics10090704.

Prognostic Role and Clinical Significance of Tumor-Infiltrating Lymphocyte (TIL) and Programmed Death Ligand 1 (PD-L1) Expression in Triple-Negative Breast Cancer (TNBC): A Systematic Review and Meta-Analysis Study

Parisa Lotfinejad  1   2   3   4 , Mohammad Asghari Jafarabadi  5 , Mahdi Abdoli Shadbad  2 , Tohid Kazemi  3 , Fariba Pashazadeh  1 , Siamak Sandoghchian Shotorbani  3 , Farhad Jadidi Niaragh  3 , Amir Baghbanzadeh  2 , Nafiseh Vahed  6 , Nicola Silvestris  7   8 , Behzad Baradaran  2   3   9
Affiliations
Review

Prognostic Role and Clinical Significance of Tumor-Infiltrating Lymphocyte (TIL) and Programmed Death Ligand 1 (PD-L1) Expression in Triple-Negative Breast Cancer (TNBC): A Systematic Review and Meta-Analysis Study

Parisa Lotfinejad et al. Diagnostics (Basel). .

Abstract

This meta-analysis aimed to evaluate the prognostic value of tumor-infiltrating lymphocytes (TILs) and programmed death-ligand 1 (PD-L1), their associations with the clinicopathological characteristics, and the association between their levels in patients with triple-negative breast cancer (TNBC). PubMed, EMBASE, Scopus, ProQuest, Web of Science, and Cochrane Library databases were searched to obtain the relevant papers. Seven studies with 1152 patients were included in this study. Like the level of TILs, there were no significant associations between PD-L1 expression and tumor size, tumor stage, lymph node metastasis, histological grade, and Ki67 (All p-values ≥ 0.05). Furthermore, there was no significant association between PD-L1 expression with overall survival (OS) and disease-free survival (DFS). In assessment of TILs and survival relationship, the results showed that a high level of TILs was associated with long-term OS (hazard ratios (HR) = 0.48, 95% CI: 0.30 to 0.77, p-value < 0.001) and DFS (HR = 0.53, 95% CI: 0.35 to 0.78, p-value < 0.001). The results displayed that tumoral PD-L1 expression was strongly associated with high levels of TILs in TNBC patients (OR = 8.34, 95% CI: 2.68 to 25.95, p-value < 0.001). In conclusion, the study has shown the prognostic value of TILs and a strong association between tumoral PD-L1 overexpression with TILs in TNBC patients.

Keywords: meta-analysis; prognosis; programmed cell death-ligand 1; triple-negative breast cancer; tumor-infiltrating lymphocytes.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The flow diagram of study.
Figure 2
Figure 2
Forest plot of the individual odds ratio for the relation between PD-L1 expression and clinicopathological characteristics. (A) tumor size, (B) tumor stage, (C) lymph node metastasis, (D) histological grade, (E) Ki67.
Figure 2
Figure 2
Forest plot of the individual odds ratio for the relation between PD-L1 expression and clinicopathological characteristics. (A) tumor size, (B) tumor stage, (C) lymph node metastasis, (D) histological grade, (E) Ki67.
Figure 3
Figure 3
Forest plot of the individual odds ratio for the relation between TILs and clinicopathological characteristics. (A) tumor size, (B) tumor stage, (C) lymph node metastasis.
Figure 4
Figure 4
Forest plot of individual relative risks for PD-L1 expression-related survival. (A) OS. (B) DFS.
Figure 5
Figure 5
Forest plot of individual relative risks for TILs related survival. (A) OS. (B) DFS.
Figure 6
Figure 6
Forest plot of the individual odds ratio for the relation between TILs and PD-L1 expression.
Figure 7
Figure 7
Funnel plot assessment of possible publication bias. (A) PD-L1 expression for OS. (B) PD-L1 expression for DFS. (C) TILs for OS. (D) TILs for DFS.
Figure 8
Figure 8
Risk of bias assessment in 7 studies.
See this image and copyright information in PMC

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