High PD-L1 expression was associated with poor prognosis in 870 Chinese patients with breast cancer

Oncotarget. 2015 Oct 20;6(32):33972-81. doi: 10.18632/oncotarget.5583.


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.

Keywords: ER/PR; PD-L1; breast cancer; nomogram; prognosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • B7-H1 Antigen / metabolism*
  • Breast Neoplasms / diagnosis*
  • Breast Neoplasms / metabolism*
  • Breast Neoplasms / mortality
  • China
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Gene Expression Regulation, Neoplastic*
  • Humans
  • Immunohistochemistry
  • Kaplan-Meier Estimate
  • Lymphatic Metastasis
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Metastasis
  • Neoplasm Recurrence, Local
  • Nomograms
  • Prognosis
  • Proportional Hazards Models
  • Regression Analysis
  • Treatment Outcome
  • Young Adult


  • B7-H1 Antigen
  • CD274 protein, human