title: High PD-L1 expression was associated with poor prognosis in 870 Chinese patients with breast cancer.
abstract: 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.
authors.affiliation: 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.
authors.forename: Tao
authors.initials: T
authors.lastname: Qin
authors.affiliation: 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.|Sun Yat-sen University Sun Yat-sen Memorial Hospital, Guangzhou, Guangdong, P. R. China.
authors.forename: Yin-duo
authors.initials: YD
authors.lastname: Zeng
authors.affiliation: 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.
authors.forename: Ge
authors.initials: G
authors.lastname: Qin
authors.affiliation: 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.
authors.forename: Fei
authors.initials: F
authors.lastname: Xu
authors.affiliation: 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.
authors.forename: Jia-bin
authors.initials: JB
authors.lastname: Lu
authors.affiliation: 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.
authors.forename: Wen-feng
authors.initials: WF
authors.lastname: Fang
authors.affiliation: 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.
authors.forename: Cong
authors.initials: C
authors.lastname: Xue
authors.affiliation: 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.
authors.forename: Jian-hua
authors.initials: JH
authors.lastname: Zhan
authors.affiliation: 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.
authors.forename: Xin-ke
authors.initials: XK
authors.lastname: Zhang
authors.affiliation: 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.
authors.forename: Qiu-fan
authors.initials: QF
authors.lastname: Zheng
authors.affiliation: 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.
authors.forename: Rou-jun
authors.initials: RJ
authors.lastname: Peng
authors.affiliation: 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.
authors.forename: Zhong-yu
authors.initials: ZY
authors.lastname: Yuan
authors.affiliation: 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.
authors.forename: Li
authors.initials: L
authors.lastname: Zhang
authors.affiliation: 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.
authors.forename: Shu-sen
authors.initials: SS
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D060890:B7-H1 Antigen / Q000378:metabolism*; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000378:metabolism* / Q000401:mortality; D002681:China; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis; D008875:Middle Aged; D015999:Multivariate Analysis; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D049451:Nomograms; D011379:Prognosis; D016016:Proportional Hazards Models; D012044:Regression Analysis; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D060890:B7-H1 Antigen; C423236:CD274 protein, human
keywords: ER/PR; PD-L1; breast cancer; nomogram; prognosis