CD274 and metastatic malignant neoplasm in the lymph nodes: However, Wessely found that HPV infection status and PD-L1 expression were not correlated, PD-L1 expression status was an independent prognostic marker for survival of patients with anal squamous cell carcinoma (P = 0.012) [34], and a meta-analysis demonstrated that in anogenital SCC, PD-L1 positivity had to do with a worse outcome, which might attribute to advanced age, higher tumor grade, lymph node metastasis, and HPV negativity, while in oropharynx cancer, PD-L1 expression was related to better prognosis for the reason that PD-L1 was less frequent in the aged and negative HPV status [35].