Abstract
The prognostic value of mucins expression in patients with head and neck cancer (HNC) remains controversial. To address this, a meta-analysis was performed to systematically evaluate prognostic significance of mucins expression in HNC. Electronic and manual searches were performed and a total of 20 studies including 2046 patients were selected for the final analysis. Increased mucins expression was associated with unfavorable overall survival in HNC patients (HR=1.83, 95% CI: 1.43-2.33, p=0.000). Mucins overexpression was also in correlation with more advanced TNM stage (RR=0.84, 95% CI: 0.73-0.97, p=0.017), higher risk of lymph node metastasis (RR=0.69, 95% CI: 0.57-0.84, p=0.000) and deeper invasion (RR=0.58, 95% CI: 0.44-0.76, p=0.000). These results suggested that elevated mucins expression was significantly associated with worse prognosis and more detrimental clinicopathological outcomes, revealing the promising potential of mucins as biomarkers for HNC management.
Highlights
Head and neck cancer (HNC) is a group of biologically similar cancers originating from the oral cavity, nasopharyngeal, oropharynx, hypopharynx and larynx, which mainly behave as squamous cell carcinoma histologically
Among patients accepted adjuvant therapy (AR and/or AC) along with surgery operation, no significant association was identified between positive MUC expression and poor overall survival (OS), exhibiting a sharp contrast with the patients without AT (HR = 1.96, 95% confidence intervals (CIs): 1.51-2.53, p = 0.000)
As for western countries and in situ hybridization (ISH) subgroups stratified by nationality and detecting methods respectively, no significant association was identified though a tendency was shown
Summary
Head and neck cancer (HNC) is a group of biologically similar cancers originating from the oral cavity, nasopharyngeal, oropharynx, hypopharynx and larynx, which mainly behave as squamous cell carcinoma histologically. HNC is the sixth most frequent type of malignant tumor, causing more than 400,000 deaths annually worldwide [1,2,3,4,5]. Despite great advance in multidisciplinary combined diagnosis and treatment, only 30-50% patients with HNC survive over 5 years after initial diagnosis worldwide [6]. The classic tumor, node, and metastasis (TNM) staging system is widely used for the initial diagnosis but failed to reflect the inherent biological heterogeneity especially in atypical early symptoms or concealed metastasis patients. Novel biomarkers involved in cancer development are greatly needed to stratify patients with poor prognosis of HNC in order to make optimal individualized therapy
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