A Meta-analysis Of The Correlation Between PD-L1 And Clinicopathological Factors Of Breast Cancer And Its Relationship With TCM Syndromes

Purpose:In this study,we focused on the systematic merger and comprehensive evaluation of PD-L1 expression related to the clinicopathological factors and prognosis of breast cancer were systematically combined in the 2002-2017.To study the relationship between the expression of PD-1/PD-L1 and the TCM syndrome differentiation of breast cancer.Material and method: 1.Using the way of computer retrieval,Retrieval of databases such as Pub Med,Embase,Springer Link,Cochrane Library,Wan Fang Data,CNKI,VIP,and so on,collect the paper abstracts with retrospective cohort study on the correlation between PD-L1 expression and the clinicopathological features and prognosis of breast cancer for 2002-2017,and uses the method of combining keywords and free words: Chinese search terms include breast cancer,rogranmed cell death 1 ligand 1(PD-L1).English search terms include breast cancer、breast carcinoma、Progranmed cell death 1 ligand 1(PD-L1),7-H1,CD274,CD279.And then strictly according to the inclusion and exclusion criteria for screening,and collection of information to collect information.using STATA software for meta-analysis.The NOS scale was used to evaluate the quality of the literature,and the funnel map was used to evaluate the publication migration of the literature.OR(ratio Ratio)and 95%CI(confidence interval)were used to evaluate the correlation strength.2.A total of 97 women with breast cancer who admitted to Shenyang Military Region General Hospital from December 2014 to December 2017.Immunohistochemical detection of PD-L1 expression by collecting pathological sections of patients.Analysis the relationship between the age of the patients,the constitution ratio of TCM syndrome type and the positive expression of PD-L1 and TCM syndrome type.Results: 1.The correlation of PD-L1 expression with the clinicopathological features and prognosis of breast cancer with Meta analysis A total of 20(n=11454)retrospective studies included in this meta – Analysis.The Analysis results show: The positive expression of PD-L1 had no statistical significance on the overall survival(HR=1.441,95% CI:0.835~2.488,P=0.190)and disease-free survival(HR=0.963,95% CI:0.633~1.467,P=0.862)of breast cancer patients.The difference of PD-L1 expression was correlated with Luminal A(HR=0.963,95% CI:0.633~1.467,P=0.036)and Triple negative(OR=1.647,95% CI:1.647~4.416,P<0.001)in breast cancer molecular subtypes.But There was no significant difference in the relationship between Luminal B(OR=0.836,95% CI:0.503~1.390,P=0.490)and HER-2 overexpression(OR=1.141,95% CI:0.740~1.759,P=0.551).The difference in PD-L1 expression is related to the size of the tumor(OR=1.275,95% CI:1.059~1.535,P=0.010),ER(OR=0.587,95% CI:0.365~0.946,P=0.029),PR(OR=0.514,95% CI:0.336~0.785,P=0.002)and histological grade(OR=0.609,95% CI:0.460~0.805,P<0.001)in the patients with breast cancer.Differences in PD-L1 expression are not related to age(OR=0.984,95% CI:0.906~1.069,P=0.709),lymph node metastasis(OR=1.023,95% CI:0.961~1.100,P=0.541),Ki-67(OR=1.556,95% CI:0.976~2.483,P=0.063)and HER-2(OR=1.048,95% CI:0.881~1.247,P=0.596)in patients with breast cancer 2.Relationship between PD-L1 expression and TCM syndrome type A total of 97 cases of breast cancer included in this study.The analysis of the high incidence of women’s breast cancer at the age of 41-50,38 cases accounted for 39.18% of the total number of patients.There is a statistically significant difference compared with the other four groups(p<0.05).97 cases of breast cancer patients with TCM syndrome type in syndrome of liver-qi stagnation is most common in breast cancer patients,a total of 36 cases accounted for 37.11%.The second is the following: syndrome of deficiency of both qi and blood 27 cases accounted for 27.84%,sydrome of accumulation and binding of heat-poison in 20 cases,accounting for 20.62%,14 cases of syndrome of yin deficiency of liver and kidney,accounting for 14.43%.The most common type of breast cancer was sydrome of liver-qi stagnation,sydrome of imbablance of Chong and Ren Channels,compared to the rest of the group was statistically significant(P < 0.05).There were 63 cases of PD-L1 positive expression in the 97 patients,accounting for 64.95%.syndrome of liver-qi stagnation 39 cases accounted for 73.40%,higher than the other groups,P<0.05.Conclusion: 1.The positive expression of PD-L1 was not related to OS,DFS,age,lymph node metastasis,HER-2 status,Ki-67 level and Luminal B and HER-2 overexpression in breast cancer patients.2.The positive expression of PD-L1 was positively correlated with TNBC and the size of tumor,histological grade in the patients with breast cancer.There was a negative correlation between ER positive,PR positive in breast cancer patients and type Luminal A breast cancer.3.The positive expression of PD-L1 is common in breast cancer in patients with syndrome of liver-qi stagnation.