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Immune checkpoints in solid tumors serve important roles in metastasis. The present study was designed to explore the expression of programmed cell death protein 1 (PD-1) on peripheral blood T-cell subsets and its role in the clinicopathological features and prognosis of patients with metastatic gastric cancer. The expression of PD-1 in peripheral blood T-cell subsets was detected in 100 metastatic gastric cancer patients prior to the first line chemotherapy by flow cytometric analysis. The potential associaton between the peripheral blood T-cell subsets PD-1 level and the clinicopathological features of patients with metastatic gastric cancer and the clinical outcomes was analyzed. The percent of high PD-1 expressed cluster of differentiation (CD)3 + , CD3 + CD4 + and CD3 + CD8 + T-cells was 20.4, 13.0 and 9.4%, respectively in patients with metastatic gastric cancer. The overall survival (OS) and progression-free survival (PFS) rate of the 100 patients with metastatic gastric cancer was 12.2 and 3.9 months, respectively. Kaplan-Meier curve with long-rank analysis indicated that patients with higher PD-1 + /CD3 + , PD-1 + /CD3 + CD4 + and PD-1 + /CD3 + CD8 + levels had a worse prognosis (all P&lt;0.05). Univariate and multivariate analysis revealed that high PD-1 + /CD3 + [hazard ratio (HR), 2.145; P=0.015], high PD-1 + /CD3 + CD4 + (HR, 1.866; P=0.034) and high PD-1 + /CD3 + CD8 + (HR, 1.817; P=0.033) level in peripheral blood were independent risk factors for predicting the survival time of patients with metastatic gastric cancer. High PD-1 + /CD3 + , high PD-1 + /CD3 + CD4 + and high PD-1 + /CD3 + CD8 + expression conferred a lower overall survival rate in patients with metastatic gastric cancer. These results suggest that high PD-1 expression on peripheral blood T-cell subsets may potentially be novel prognostic biomarker for metastatic gastric cancer.

High expression of programmed cell death protein 1 on peripheral blood T‑cell subsets is associated with poor prognosis in metastatic gastric cancer