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
N1 - Publisher Copyright:
© 2022 Elsevier Ltd
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 -