Prognostic and Clinicopathological Significance of Telomerase Reverse Transcriptase Upregulation in Oral Cancer: A Systematic Review and Meta-Analysis
Metadatos
Afficher la notice complèteAuteur
González Moles, Miguel Ángel; Moya González, Eloísa; García Ferrera, Alberto; Nieto Casado, Paola; Ramos García, PabloEditorial
MDPI
Materia
Telomerase reverse transcriptase (TERT) hTERT hEST2 Replicative immortality Oral cancer Prognosis Biomarker Systematic review Meta-analysis
Date
2022-07-28Referencia bibliográfica
González-Moles, M.Á... [et al.]. Prognostic and Clinicopathological Significance of Telomerase Reverse Transcriptase Upregulation in Oral Cancer: A Systematic Review and Meta-Analysis. Cancers 2022, 14, 3673. [https://doi.org/10.3390/cancers14153673]
Résumé
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,
p < 0.001), disease-free survival (HR = 4.03, 95% CI = 1.80–9.05, p = 0.001), and higher histological
grade OSCC (odds ratio [OR] = 3.20, 95% CI = 1.83–5.62, p < 0.001). These large effect sizes were
consistently obtained by homogeneous subgroups (p > 0.10, I2 = 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.