Abstract
BackgroundThe clinicopathological significance of cyclin D1 overexpression and prognosis of oral squamous cell carcinoma has not been fully quantified. We performed a comprehensive meta-analysis for evaluation of cyclin D1 overexpression in oral squamous cell carcinoma to determine the strength of this association.MethodsUsing both medical subheadings and free terms, we searched PubMed, Embase and the Institute for Scientific Information Web of Science for all eligible studies published before Nov. 2013. We retrieved 1674 citations, determining that 15 met the selection criteria. We used the odds ratio (OR) and hazard ratio (HR) as the common measures of association to quantitatively determine the correlation between cyclin D1 overexpression and outcomes of oral cancer. We performed a meta-analysis and heterogeneity, sensitivity, and subgroup analyses to clarify and validate the pooled results.ResultsThe pooled results provided compelling evidence that cyclin D1 overexpression was significantly correlated with increased tumor size (OR = 1.617, 95% confidence interval [CI] = 1.046–2.498, p = 0.031), lymphoid node metastasis (OR = 2.035, 95% CI = 1.572–2.635, p<0.001), tumor differentiation (OR = 1.976, 95% CI = 1.363–2.866, p<0.001), and advancement of clinical stages (OR = 1.516, 95% CI = 1.140–2.015, p = 0.004), and adversely influenced overall survival of OSCC patients (HR = 1.897, 95% CI = 1.577–2.282, p<0.001). The strength of association varied in different oral cavity subsites.ConclusionOur findings indicated that cyclin D1 expression correlates with detrimental clinicopathological outcome and poor prognosis in oral squamous cell carcinoma. Our results may be useful in the management of oral cancer.
Highlights
Oral squamous cell carcinoma (OSCC) is a common malignancy in the head and neck region, with significant incidence and mortality
Studies were eligible for inclusion if: (1) they were original articles published in either English or Chinese; (2) they focused on the association of cyclin D1 overexpression with high-risk clinicopathological factors and OSCC prognosis (3) they used immunohistochemistry (IHC) as the main method to examine the cyclin D1 expression in OSCC specimens
We summarized information associating cyclin D1 overexpression with other clinicopathological parameters as the topic of interest reported in the included studies, including nodal metastasis, histological grade and clinical stage (Table 2 and Fig. 2)
Summary
Oral squamous cell carcinoma (OSCC) is a common malignancy in the head and neck region, with significant incidence and mortality. The conventional prognostic tool for cancers is the tumor-node-metastasis (TNM) system, in which lymph node metastasis is the most relevant [3]. The biological phenotypes of tumors are often divergent despite identical staging, resulting in different clinical outcomes and response to the selected treatment [4]. Clarifying the correlation between biological characteristics or molecular biomarkers and the aggressiveness of oral cancer may provide be of significant benefit for predicting clinical outcomes and determining the optimal individualized therapy for each patient. The clinicopathological significance of cyclin D1 overexpression and prognosis of oral squamous cell carcinoma has not been fully quantified. We performed a comprehensive meta-analysis for evaluation of cyclin D1 overexpression in oral squamous cell carcinoma to determine the strength of this association
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