Significance of p53 overexpression in the prediction of the malignant transformation risk of oral potentially malignant disorders: A systematic review and meta-analysis

Pablo Ramos-García; Miguel Ángel González-Moles; Saman Warnakulasuriya

doi:10.1016/j.oraloncology.2022.105734

Significance of p53 overexpression in the prediction of the malignant transformation risk of oral potentially malignant disorders: A systematic review and meta-analysis

Pablo Ramos-García, Miguel Ángel González-Moles^*, Saman Warnakulasuriya

^*Corresponding author for this work

King's College London

Research output: Contribution to journal › Review article › peer-review

10 Citations (Scopus)

Abstract

Objectives: To evaluate the current evidence in relation to the predictive value of p53 overexpression as a biomarker of the malignant transformation risk in oral potentially malignant disorders (OPMD). Material and methods: We searched PubMed, Embase, Web of Science and Scopus for studies published before July-2021, not restricted by date or publication language, with longitudinal design and assessing p53 overexpression by immunohistochemistry. We evaluated the quality of primary-level studies using QUIPS tool. We carried out meta-analyses, examined inter-study heterogeneity through subgroup and meta-regression analyses, and performed sensitivity and small-study effects analyses to test the stability and reliability of results. Results: Twenty four studies (1,210 patients) met inclusion criteria. P53 overexpression was associated with a statistically significant about 2 fold risk (RR = 1.88, 95 %CI = 1.39–2.56, p < 0.001). Leukoplakia maintained this significant relationship after subgroup meta-analysis (p = 0.002). Regarding the immunohistochemical technique, better results were obtained by the subgroups using anti-p53 DO7 antibody (p = 0.001), at high concentration (dilution < 1: 100, p < 0.001), incubated for long periods (overnight, p = 0.02), and at low temperature (4 °C, p = 0.007). Furthermore, meta-regression analysis showed that the association between p53 overexpression and higher oral cancer risk was independent of the presence and/or severity of epithelial dysplasia (p > 0.05). Conclusion: Our systematic review and meta-analysis supports the assessment of p53 overexpression in the prediction of the malignant transformation risk of OPMD.

Original language	English
Article number	105734
Journal	ORAL ONCOLOGY
Volume	126
DOIs	https://doi.org/10.1016/j.oraloncology.2022.105734
Publication status	Published - Mar 2022

Keywords

Dysplasia
Leukoplakia
Malignant transformation
Meta-analysis
Oral cancer
Oral lichen planus
Oral potentially malignant disorders
P53
Systematic review
TP53

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.oraloncology.2022.105734

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@article{acf5abc40cf5427aa5f7adeeaa3eaaaf,

title = "Significance of p53 overexpression in the prediction of the malignant transformation risk of oral potentially malignant disorders: A systematic review and meta-analysis",

abstract = "Objectives: To evaluate the current evidence in relation to the predictive value of p53 overexpression as a biomarker of the malignant transformation risk in oral potentially malignant disorders (OPMD). Material and methods: We searched PubMed, Embase, Web of Science and Scopus for studies published before July-2021, not restricted by date or publication language, with longitudinal design and assessing p53 overexpression by immunohistochemistry. We evaluated the quality of primary-level studies using QUIPS tool. We carried out meta-analyses, examined inter-study heterogeneity through subgroup and meta-regression analyses, and performed sensitivity and small-study effects analyses to test the stability and reliability of results. Results: Twenty four studies (1,210 patients) met inclusion criteria. P53 overexpression was associated with a statistically significant about 2 fold risk (RR = 1.88, 95 %CI = 1.39–2.56, p < 0.001). Leukoplakia maintained this significant relationship after subgroup meta-analysis (p = 0.002). Regarding the immunohistochemical technique, better results were obtained by the subgroups using anti-p53 DO7 antibody (p = 0.001), at high concentration (dilution < 1: 100, p < 0.001), incubated for long periods (overnight, p = 0.02), and at low temperature (4 °C, p = 0.007). Furthermore, meta-regression analysis showed that the association between p53 overexpression and higher oral cancer risk was independent of the presence and/or severity of epithelial dysplasia (p > 0.05). Conclusion: Our systematic review and meta-analysis supports the assessment of p53 overexpression in the prediction of the malignant transformation risk of OPMD.",

keywords = "Dysplasia, Leukoplakia, Malignant transformation, Meta-analysis, Oral cancer, Oral lichen planus, Oral potentially malignant disorders, P53, Systematic review, TP53",

author = "Pablo Ramos-Garc{\'i}a and Gonz{\'a}lez-Moles, {Miguel {\'A}ngel} and Saman Warnakulasuriya",

note = "Publisher Copyright: {\textcopyright} 2022 Elsevier Ltd",

year = "2022",

month = mar,

doi = "10.1016/j.oraloncology.2022.105734",

language = "English",

volume = "126",

journal = "ORAL ONCOLOGY",

issn = "1368-8375",

publisher = "Elsevier",

}

Significance of p53 overexpression in the prediction of the malignant transformation risk of oral potentially malignant disorders : A systematic review and meta-analysis. / Ramos-García, Pablo; González-Moles, Miguel Ángel; Warnakulasuriya, Saman.

In: ORAL ONCOLOGY, Vol. 126, 105734, 03.2022.

Research output: Contribution to journal › Review article › peer-review

TY - JOUR

T1 - Significance of p53 overexpression in the prediction of the malignant transformation risk of oral potentially malignant disorders

T2 - A systematic review and meta-analysis

AU - Ramos-García, Pablo

AU - González-Moles, Miguel Ángel

AU - Warnakulasuriya, Saman

PY - 2022/3

Y1 - 2022/3

N2 - Objectives: To evaluate the current evidence in relation to the predictive value of p53 overexpression as a biomarker of the malignant transformation risk in oral potentially malignant disorders (OPMD). Material and methods: We searched PubMed, Embase, Web of Science and Scopus for studies published before July-2021, not restricted by date or publication language, with longitudinal design and assessing p53 overexpression by immunohistochemistry. We evaluated the quality of primary-level studies using QUIPS tool. We carried out meta-analyses, examined inter-study heterogeneity through subgroup and meta-regression analyses, and performed sensitivity and small-study effects analyses to test the stability and reliability of results. Results: Twenty four studies (1,210 patients) met inclusion criteria. P53 overexpression was associated with a statistically significant about 2 fold risk (RR = 1.88, 95 %CI = 1.39–2.56, p < 0.001). Leukoplakia maintained this significant relationship after subgroup meta-analysis (p = 0.002). Regarding the immunohistochemical technique, better results were obtained by the subgroups using anti-p53 DO7 antibody (p = 0.001), at high concentration (dilution < 1: 100, p < 0.001), incubated for long periods (overnight, p = 0.02), and at low temperature (4 °C, p = 0.007). Furthermore, meta-regression analysis showed that the association between p53 overexpression and higher oral cancer risk was independent of the presence and/or severity of epithelial dysplasia (p > 0.05). Conclusion: Our systematic review and meta-analysis supports the assessment of p53 overexpression in the prediction of the malignant transformation risk of OPMD.

AB - Objectives: To evaluate the current evidence in relation to the predictive value of p53 overexpression as a biomarker of the malignant transformation risk in oral potentially malignant disorders (OPMD). Material and methods: We searched PubMed, Embase, Web of Science and Scopus for studies published before July-2021, not restricted by date or publication language, with longitudinal design and assessing p53 overexpression by immunohistochemistry. We evaluated the quality of primary-level studies using QUIPS tool. We carried out meta-analyses, examined inter-study heterogeneity through subgroup and meta-regression analyses, and performed sensitivity and small-study effects analyses to test the stability and reliability of results. Results: Twenty four studies (1,210 patients) met inclusion criteria. P53 overexpression was associated with a statistically significant about 2 fold risk (RR = 1.88, 95 %CI = 1.39–2.56, p < 0.001). Leukoplakia maintained this significant relationship after subgroup meta-analysis (p = 0.002). Regarding the immunohistochemical technique, better results were obtained by the subgroups using anti-p53 DO7 antibody (p = 0.001), at high concentration (dilution < 1: 100, p < 0.001), incubated for long periods (overnight, p = 0.02), and at low temperature (4 °C, p = 0.007). Furthermore, meta-regression analysis showed that the association between p53 overexpression and higher oral cancer risk was independent of the presence and/or severity of epithelial dysplasia (p > 0.05). Conclusion: Our systematic review and meta-analysis supports the assessment of p53 overexpression in the prediction of the malignant transformation risk of OPMD.

KW - Dysplasia

KW - Leukoplakia

KW - Malignant transformation

KW - Meta-analysis

KW - Oral cancer

KW - Oral lichen planus

KW - Oral potentially malignant disorders

KW - P53

KW - Systematic review

KW - TP53

UR - http://www.scopus.com/inward/record.url?scp=85123676439&partnerID=8YFLogxK

U2 - 10.1016/j.oraloncology.2022.105734

DO - 10.1016/j.oraloncology.2022.105734

M3 - Review article

AN - SCOPUS:85123676439

SN - 1368-8375

VL - 126

JO - ORAL ONCOLOGY

JF - ORAL ONCOLOGY

M1 - 105734

ER -

Significance of p53 overexpression in the prediction of the malignant transformation risk of oral potentially malignant disorders: A systematic review and meta-analysis

Abstract

Keywords

UN SDGs

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