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Objective:The programmed cell death-1 receptor/programmed cell death-1 ligand(PD-1/PD-L1) pathway plays a crucial role in tumor evasion from host immunity.This study was designed to evaluate the association between circulating PD-L1 expression and prognosis in patients with advanced gastric cancer.Methods:Totally 80 advanced gastric cancer patients and 40 health controls from Beijing Cancer Hospital were enrolled in the present study.Circulating PD-L1 expression was tested by enzymelinked immunosorbent assay(ELISA).The associations between the expression level of PD-L1 and clinicopathological features and prognosis were analyzed statistically.Results:Expression of PD-L1 in advanced gastric cancer patients was significantly up-regulated compared with health people(P=0.006).The expression of PD-L1 was significantly correlated with differentiation and lymph node metastasis(P=0.026 and P=0.041,respectively).Although we didn't find significant difference in all advanced gastric cancer patients with different PD-L1 expression,the adenocarcinoma patients with higher up-regulated PD-L1 expression had much better prognosis than low expression patients(65.6% vs.44.7%,P=0.028).Conclusions:PD-L1 was elevated in advance gastric cancer patients and may play an important role in tumor immune evasion and patients prognosis.