Background High expression of programmed death ligand‐1 (PD‐L1) has been related to good response to immunotherapy patients with gastric cancer (GC). However, the influence of Helicobacter pylori (HP) infection on PD‐L1 expression in GC remains unknown. A meta‐analysis was performed to evaluate the association between HP infection and PD‐L1 expression in GC. Methods Observational studies that investigated the relationship between HP infection and PD‐L1 expression in patients with GC were obtained by search electronic databases, including PubMed, Embase, Cochrane's Library and Web of Science. A random‐effect model incorporating the possible influence of between‐study heterogeneity was used to pool the results. Results Ten studies with 1870 patients with GC contributed to the meta‐analysis. Pooled results showed that HP infection was significantly associated with the tumour expression of PD‐L1 (odds ratio [OR]: 1.90, 95% confidence interval: 1.33–2.72, p < .001; I2 = 53%). Subgroup analyses showed that the association between HP infection and PD‐L1 expression in GC was not significantly affected by sample size, methods for PD‐L1 evaluation and quality score (p for subgroup analyses all >.05). However, a stronger association was observed in studies with higher prevalence of HP infection (≥35%, OR: 2.58) as compared with those with lower prevalence (<35%, OR: 1.45, p for subgroup difference = .04). Conclusion Helicobacter pylori infection in GC patients is associated with tumour expression of PD‐L1, suggesting HP infection may be a predictor of good response to immunotherapy in GC.
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