{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T20:44:17Z","timestamp":1788813857575,"version":"build-2803163510"},"reference-count":28,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T00:00:00Z","timestamp":1769731200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000057","name":"National Institute of General Medical Sciences","doi-asserted-by":"publisher","award":["U54 GM115458"],"award-info":[{"award-number":["U54 GM115458"]}],"id":[{"id":"10.13039\/100000057","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Investigative Medicine"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:p>\n                    Programmed death-ligand 1 (PD-L1) is an immune checkpoint protein that tumors exploit to evade T-cell\u2013mediated surveillance. While PD-L1 overexpression has been linked to advanced disease and poor prognosis in many cancers, its clinicopathological significance in differentiated thyroid cancer (DTC) remains unclear. We conducted a systematic review and meta-analysis by searching MEDLINE, Embase, the Cochrane Library, and PubMed from inception to 2 January, 2023. Eligible studies reported PD-L1 immunohistochemical positivity in DTC and its correlation with clinicopathological features. Data were extracted in duplicate, and study quality was assessed with a modified Newcastle-Ottawa Scale (NOS). Pooled odds ratios (ORs) or hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated using random-effects models. Heterogeneity was evaluated by the I\n                    <jats:sup>2<\/jats:sup>\n                    value. Twelve retrospective studies met the inclusion criteria. All were retrospective and of moderate quality. High tumoral PD-L1 expression was significantly associated with the presence of lymphovascular invasion (LVI) (pooled OR 4.2, 95% CI 1.7\u201310.5), extrathyroidal extension (ETE) (pooled OR 1.7, 95% CI 1.2\u20132.4;\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.005) and distant metastases (pooled OR 4.6, 95% CI 1.6\u201313.0;\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.004). In other words, PD-L1\u2013positive tumors were more likely to exhibit local invasion and distant metastasis. By contrast, PD-L1 status showed no significant association with tumor size, multifocality, lymph node metastasis, AJCC tumor stage, disease recurrence, or disease-specific mortality (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&gt;\u20090.05 for all). Between-study heterogeneity was not significant for our key outcomes. PD-L1 overexpression in DTC is associated with a higher risk of local invasion and distant metastases, suggesting that PD-L1 may contribute to tumor progression via immune evasion.\n                  <\/jats:p>","DOI":"10.1177\/10815589261415900","type":"journal-article","created":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T11:15:26Z","timestamp":1767957326000},"page":"527-535","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Programmed death-ligand 1 expression is associated with local invasion and distant metastases in differentiated thyroid cancer: Systematic review and meta-analysis"],"prefix":"10.1177","volume":"74","author":[{"given":"Rajan K.","family":"Mediratta","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Loyola University Medical Center, Maywood, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilia","family":"Bernstein","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Internal Medicine, West Virginia University School of Medicine, Charleston, WV, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, University of Nebraska Medical Center, Omaha, NE, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cindy","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Leon S. McGoogan Health Sciences Library, University of Nebraska Medical Center, Omaha, NE, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Apar Kishor","family":"Ganti","sequence":"additional","affiliation":[{"name":"Division of Oncology and Hematology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA"},{"name":"Division of Oncology and Hematology, Department of Internal Medicine, VA Nebraska-Western Iowa Health Care System, Omaha, NE, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamid","family":"Band","sequence":"additional","affiliation":[{"name":"Eppley Institute for Research in Cancer and Allied Diseases, University of Nebraska Medical Center, Omaha, NE, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert G.","family":"Bennett","sequence":"additional","affiliation":[{"name":"Division of Diabetes, Endocrinology and Metabolism, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA"},{"name":"Department of Biochemistry and Molecular Biology, University of Nebraska Medical Center, Omaha, NE, USA"},{"name":"Department of Biochemistry and Molecular Biology, VA Nebraska-Western Iowa Health Care System, Omaha, NE, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anupam","family":"Kotwal","sequence":"additional","affiliation":[{"name":"Division of Diabetes, Endocrinology and Metabolism, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,1,30]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.17305\/bjbms.2022.7953"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1530\/ERC-16-0421"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.3892\/ol.2021.12814"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2022.0040"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2015.0020"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2020.0272"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2024.0072"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2017.0441"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000025315"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12022-020-09630-5"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.recesp.2021.06.016"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2016.01.021"},{"issue":"4","key":"e_1_3_2_14_2","article-title":"Evidence-based statistical analysis and methods in biomedical research (SAMBR) checklists according to design features","volume":"3","author":"Dwivedi AK","year":"2020","unstructured":"Dwivedi AK, Shukla R. Evidence-based statistical analysis and methods in biomedical research (SAMBR) checklists according to design features. 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