Research Paper Volume 13, Issue 2 pp 2279—2293

The clinicopathological significance and prognostic value of programmed death-ligand 1 in prostate cancer: a meta-analysis of 3133 patients

Haixiang Shen1, *, , Jin Liu2, *, , Guoliang Sun3, , Libin Yan1, , Qinchen Li1, , Zhize Wang1, , Liping Xie1, ,

  • 1 Department of Urology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
  • 2 Department of Surgical Oncology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
  • 3 Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
* Equal contribution

Received: March 30, 2020       Accepted: October 31, 2020       Published: December 9, 2020
How to Cite

Copyright: © 2021 Shen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Background: Programmed death-ligand 1 (PD-L1) is considered an adverse factor predicting poor prognosis in various cancers, but the significance of PD-L1 expression for the prognosis of prostate cancer (PCa) is still unclear. We aimed to investigate the clinicopathological significance and prognostic value of PD-L1 expression in PCa.

Methods: Studies were retrieved from PubMed, Web of Science, Cochrane Library and Embase before March 23, 2020. Odds ratios (ORs) and hazard ratios (HRs) with 95% confidence intervals (CIs) were obtained to assess the results. Begg’s test was applied to evaluate publication bias.

Results: Fourteen studies involving 3133 cases were analyzed. The pooled data showed that both PD-L1 protein expression and PD-L1 DNA methylation (mPD-L1) were negatively associated with biochemical recurrence-free survival, with HRs of 1.67 (95% CI = 1.38-2.06, p < 0.001) and 2.23 (95% CI = 1.51-3.29, p < 0.001), respectively. In addition, PD-L1 overexpression was significantly related to advanced tumor stage (OR = 1.40, 95% CI= 1.13-1.75, p = 0.003), positive surgical margin (OR = 1.36, 95% CI = 1.03-1.78, p = 0.028), higher Gleason score (OR = 1.81, 95% CI = 1.35-2.42, p < 0.001) and androgen receptor positivity (OR = 2.20, 95% CI = 1.61-3.01, p < 0.001), while no significant correlation with age (p = 0.122), preoperative PSA (p = 0.796) or nodal status (p = 0.113) was observed.

Conclusions: The study revealed that high expression of PD-L1 was related to unfavorable prognosis and advanced clinicopathological factors in PCa patients.


PD-L1: programmed cell death ligand 1; PCa: prostate cancer; OR: Odds ratio; HR: hazard ratio; CI: confidence interval; mPD-L1: PD-L1 DNA methylation; BCR-FS: biochemical recurrence-free survival; PD-1: programmed cell death 1; PSA: prostate specific antigen; PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses; MeSH: medical subject headings; NOS: Newcastle-Ottawa Scale; CRPC: castration-resistant prostate cancer; HSPC: hormonal sensitive prostate cancer; AR: androgen receptor; FDA: Food and Drug Administration; ADT: androgen deprivation therapy.