Prognostic and Clinicopathological Significance of Telomerase Reverse Transcriptase Upregulation in Oral Cancer: A Systematic Review and Meta-Analysis
The aim of this systematic review and meta-analysis was to evaluate the current evidence on the prognostic and clinicopathological significance value of telomerase reverse transcriptase (TERT) upregulation in patients with oral squamous cell carcinoma (OSCC). PubMed, Embase, Web of Science, and Scop...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-07-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/14/15/3673 |
| _version_ | 1797442626933227520 |
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| author | Miguel Ángel González-Moles Eloísa Moya-González Alberto García-Ferrera Paola Nieto-Casado Pablo Ramos-García |
| author_facet | Miguel Ángel González-Moles Eloísa Moya-González Alberto García-Ferrera Paola Nieto-Casado Pablo Ramos-García |
| author_sort | Miguel Ángel González-Moles |
| collection | DOAJ |
| description | The aim of this systematic review and meta-analysis was to evaluate the current evidence on the prognostic and clinicopathological significance value of telomerase reverse transcriptase (TERT) upregulation in patients with oral squamous cell carcinoma (OSCC). PubMed, Embase, Web of Science, and Scopus were searched for studies published before April 2022, not restricted by date or publication language. The methodological quality of primary-level studies was critically assessed using the Quality in Prognosis Studies (QUIPS) tool. We carried out meta-analyses, explored heterogeneity and its sources, and performed subgroup, meta-regression, sensitivity, and small-study effects analyses. Twenty-one studies (1698 patients) met inclusion criteria. TERT protein overexpression was significantly associated with worse overall survival (hazard ratio [HR] = 3.01, 95% CI = 1.70–5.35, <i>p</i> < 0.001), disease-free survival (HR = 4.03, 95% CI = 1.80–9.05, <i>p</i> = 0.001), and higher histological grade OSCC (odds ratio [OR] = 3.20, 95% CI = 1.83–5.62, <i>p</i> < 0.001). These large effect sizes were consistently obtained by homogeneous subgroups (<i>p</i> > 0.10, I<sup>2</sup> = 0.0, respectively), which reflects a high quality of evidence. On the other hand, TERT gene mutations obtained constantly nonsignificant null effect sizes for all outcomes investigated, evidencing no prognostic or clinicopathological value. In conclusion, our findings indicate that TERT upregulation is a prognostic indicator of poor survival in oral cancer. Our findings support the immunohistochemical assessment of TERT overexpression, which could probably be incorporated into the prognostic evaluation of OSCC. |
| first_indexed | 2024-03-09T12:44:40Z |
| format | Article |
| id | doaj.art-30910a268d5b4f8f96cd639026e64534 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-09T12:44:40Z |
| publishDate | 2022-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-30910a268d5b4f8f96cd639026e645342023-11-30T22:13:53ZengMDPI AGCancers2072-66942022-07-011415367310.3390/cancers14153673Prognostic and Clinicopathological Significance of Telomerase Reverse Transcriptase Upregulation in Oral Cancer: A Systematic Review and Meta-AnalysisMiguel Ángel González-Moles0Eloísa Moya-González1Alberto García-Ferrera2Paola Nieto-Casado3Pablo Ramos-García4School of Dentistry, University of Granada, 18011 Granada, SpainSchool of Dentistry, University of Granada, 18011 Granada, SpainSchool of Dentistry, University of Granada, 18011 Granada, SpainSchool of Dentistry, University of Granada, 18011 Granada, SpainSchool of Dentistry, University of Granada, 18011 Granada, SpainThe aim of this systematic review and meta-analysis was to evaluate the current evidence on the prognostic and clinicopathological significance value of telomerase reverse transcriptase (TERT) upregulation in patients with oral squamous cell carcinoma (OSCC). PubMed, Embase, Web of Science, and Scopus were searched for studies published before April 2022, not restricted by date or publication language. The methodological quality of primary-level studies was critically assessed using the Quality in Prognosis Studies (QUIPS) tool. We carried out meta-analyses, explored heterogeneity and its sources, and performed subgroup, meta-regression, sensitivity, and small-study effects analyses. Twenty-one studies (1698 patients) met inclusion criteria. TERT protein overexpression was significantly associated with worse overall survival (hazard ratio [HR] = 3.01, 95% CI = 1.70–5.35, <i>p</i> < 0.001), disease-free survival (HR = 4.03, 95% CI = 1.80–9.05, <i>p</i> = 0.001), and higher histological grade OSCC (odds ratio [OR] = 3.20, 95% CI = 1.83–5.62, <i>p</i> < 0.001). These large effect sizes were consistently obtained by homogeneous subgroups (<i>p</i> > 0.10, I<sup>2</sup> = 0.0, respectively), which reflects a high quality of evidence. On the other hand, TERT gene mutations obtained constantly nonsignificant null effect sizes for all outcomes investigated, evidencing no prognostic or clinicopathological value. In conclusion, our findings indicate that TERT upregulation is a prognostic indicator of poor survival in oral cancer. Our findings support the immunohistochemical assessment of TERT overexpression, which could probably be incorporated into the prognostic evaluation of OSCC.https://www.mdpi.com/2072-6694/14/15/3673telomerase reverse transcriptase (TERT)hTERThEST2replicative immortalityoral cancerprognosis |
| spellingShingle | Miguel Ángel González-Moles Eloísa Moya-González Alberto García-Ferrera Paola Nieto-Casado Pablo Ramos-García Prognostic and Clinicopathological Significance of Telomerase Reverse Transcriptase Upregulation in Oral Cancer: A Systematic Review and Meta-Analysis Cancers telomerase reverse transcriptase (TERT) hTERT hEST2 replicative immortality oral cancer prognosis |
| title | Prognostic and Clinicopathological Significance of Telomerase Reverse Transcriptase Upregulation in Oral Cancer: A Systematic Review and Meta-Analysis |
| title_full | Prognostic and Clinicopathological Significance of Telomerase Reverse Transcriptase Upregulation in Oral Cancer: A Systematic Review and Meta-Analysis |
| title_fullStr | Prognostic and Clinicopathological Significance of Telomerase Reverse Transcriptase Upregulation in Oral Cancer: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Prognostic and Clinicopathological Significance of Telomerase Reverse Transcriptase Upregulation in Oral Cancer: A Systematic Review and Meta-Analysis |
| title_short | Prognostic and Clinicopathological Significance of Telomerase Reverse Transcriptase Upregulation in Oral Cancer: A Systematic Review and Meta-Analysis |
| title_sort | prognostic and clinicopathological significance of telomerase reverse transcriptase upregulation in oral cancer a systematic review and meta analysis |
| topic | telomerase reverse transcriptase (TERT) hTERT hEST2 replicative immortality oral cancer prognosis |
| url | https://www.mdpi.com/2072-6694/14/15/3673 |
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