本系统综述和荟萃分析旨在评估β-catenin异常表达的预后和临床病理意义(通过膜表达的免疫组织化学损失评估,细胞质和核表达)在口腔鳞状细胞癌(OSCC)中。我们通过PubMed搜索了2021年10月之前发表的初级研究,Embase,WebofScience,Scopus,和谷歌学者,对其出版日期或语言没有限制。我们使用QUIPS工具评估了研究的方法学质量和偏倚风险,进行了荟萃分析,探索不同亚组和元回归的异质性及其来源,并进行了敏感性和小研究效应分析。41项研究(2746例患者)符合纳入标准。β-catenin的异常免疫组织化学表达与不良总生存期有统计学关联(HR=1.77,95%CI=1.20-2.60,p=0.004),无病生存率(HR=2.44,95%CI=1.10-5.50,p=0.03),N+状态(OR=2.39,95%CI=1.68-3.40,p<0.001),临床分期较高(OR=2.40,95%CI=1.58-3.63,p<0.001),较大的肿瘤大小(OR=1.76,95%CI=1.23-2.53,p=0.004),中-低分化OSCC(OR=1.57,95%CI=1.09-2.25,p=0.02)。在大多数meta分析中,细胞膜中β-catenin的丢失显示出最大的效应大小(对于不良的总生存率[HR=2.37,95%CI=1.55-3.62,p<0.001],N+状态[OR=3.44,95%CI=2.40-4.93,p<0.001]和更高的临床分期[OR=2.51,95%CI=1.17-5.35,p=0.02])。总之,我们的研究结果表明,β-catenin异常表达的免疫组织化学评估可作为评估OSCC患者的额外和补充的常规预后生物标志物.
This systematic review and meta-analysis aims to evaluate the prognostic and clinicopathological significance of the aberrant expression of β-catenin (assessed through the immunohistochemical loss of membrane expression, cytoplasmic and nuclear expression) in oral squamous cell carcinoma (OSCC). We searched for primary-level studies published before October-2021 through PubMed, Embase, Web of Science, Scopus, and Google Scholar, with no limitation in regard to their publication date or language. We evaluated the methodological quality and risk of bias of the studies included using the QUIPS tool, carried out meta-analyses, explored heterogeneity and their sources across subgroups and meta-regression, and conducted sensitivity and small-study effects analyses. Forty-one studies (2746 patients) met inclusion criteria. The aberrant immunohistochemical expression of β-catenin was statistically associated with poor overall survival (HR = 1.77, 95% CI = 1.20-2.60, p = 0.004), disease-free survival (HR = 2.44, 95% CI = 1.10-5.50, p = 0.03), N+ status (OR = 2.39, 95% CI = 1.68-3.40, p < 0.001), higher clinical stage (OR = 2.40, 95% CI = 1.58-3.63, p < 0.001), higher tumour size (OR = 1.76, 95% CI = 1.23-2.53, p = 0.004), and moderately-poorly differentiated OSCC (OR = 1.57, 95% CI = 1.09-2.25, p = 0.02). The loss of β-catenin in the cell membrane showed the largest effect size in most of meta-analyses (singularly for poor overall survival [HR = 2.37, 95% CI = 1.55-3.62, p < 0.001], N+ status [OR = 3.44, 95% CI = 2.40-4.93, p < 0.001] and higher clinical stage [OR = 2.51, 95% CI = 1.17-5.35, p = 0.02]). In conclusion, our findings indicate that immunohistochemical assessment of the aberrant expression of β-catenin could be incorporated as an additional and complementary routine prognostic biomarker for the assessment of patients with OSCC.