Predictive value of CDKN2A/p16INK4a expression in the malignant transformation of oral potentially malignant disorders: Systematic review and meta-analysis

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Predictive value of CDKN2A/p16INK4a expression in the malignant transformation of oral potentially malignant disorders: Systematic review and meta-analysisAuthor(s)
Date
2023-06-29Citation
Lorenzo-Pouso AI, Caponio VCA, Vieira E Silva FF, Pérez-Jardón A, Álvarez-Calderón-Iglesias Ó, Gándara-Vila P, Pannone G, Pérez-Sayáns M. Predictive value of CDKN2A/p16INK4a expression in the malignant transformation of oral potentially malignant disorders: Systematic review and meta-analysis. Pathol Res Pract. 2023 Aug;248:154656. doi: 10.1016/j.prp.2023.154656. Epub 2023 Jun 29. PMID: 37406376.
Abstract
[Abstract] Background: Management of oral potentially malignant disorders (OPMDs) is still challenging. Despite the
diagnostic ascertainment by bioptic examination, this method is poorly informative of the prognosis and subsequent
malignant transformation. Prognosis is based on histological findings by grading of dysplasia. Immunohistochemical
expression of p16INK4a has been investigated in different studies, with controversial results. In
this scenario, we systematically revised the current evidence about p16INK4a immunohistochemical expression
and the risk of malignization of OPMDs.
Material and methods: After a proper set of keywords combination, 5 databases were accessed and screened to
select eligible studies. The protocol was previously registered on PROSPERO (Protocol ID: CRD42022355931).
Data were obtained directly from the primary studies as a measure to determine the relationship between
CDKN2A/P16INK4a expression and the malignant transformation of OPMDs. Heterogeneity and publication bias
were investigated by different tools, such as Cochran’s Q test, Galbraith plot and Egger and Begg Mazumdar’s
rank tests.
Results: Meta-analysis revealed a twofold increased risk to malignant development (RR = 2.01, 95% CI =
1.36–2.96 - I2 = 0%). Subgroup analysis did not highlight any relevant heterogeneity. Galbraith plot showed that
no individual study could be considered as an important outlier.
Conclusion: Pooled analysis showed that p16INK4a assessment may arise adjunct tool to dysplasia grading, leading
to an optimized determination of the potential progression to cancer of OPMDs. The p16INK4a overexpression
analysis by immunohistochemistry techniques has a multitude of virtues that may facilitate its incorporation in
the day-to-day prognostic study of OPMDs.
Keywords
Immunohistochemistry
Inmunohistoquímica
Meta-analysis
Metaanálisis
OPMD
Prognosis
p16INK4a Gen
p16INK4a Gene
Inmunohistoquímica
Meta-analysis
Metaanálisis
OPMD
Prognosis
p16INK4a Gen
p16INK4a Gene
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Atribución-NoComercial-SinDerivadas 3.0 España