Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain.
ORALRES Group, Health Research Institute of Santiago de Compostela (FIDIS), 15782 Santiago de Compostela, Spain.
Int J Mol Sci. 2022 Oct 8;23(19):11937. doi: 10.3390/ijms231911937.
Head and neck cancer (HNC) is an ascending and agressive disease. The search for new molecular markers is emerging to solve difficulties in diagnosis, risk management, prognosis and effectiveness of treatments. Proteins related to apoptotic machinery have been identified as potential biomarkers. Caspase 3 is the main effector caspase and has a key role in apoptosis. The objective of this systematic review and meta-analysis is to review studies that analyze changes in Caspase 3 and Cleaved Caspase 3 expression both in oral premalignant disorders (OPMD) as well as in head and neck cancer (HNC). This study also proposes to review the prognostic values associated with HNC according to the expression of Caspase 3. Medline (via PubMed), EMBASE, Scopus, Cochrane, Web of Science and Grey Literature Database were screened from inception to june of 2022 and 18 studies were selected and 8 were included in the prognostic meta-analysis. Results related to the comparison of Caspase 3 expression demonstrated similar expression of Caspase 3 in HNC, with an average of 51.9% (9.5-98.1) showing high/moderate expression compared to 45.7% (14.6-84.7) in OPMD. Of interest, Cleaved Caspase 3 resulted incresed in HNC when compared with OPMD, being 73.3% (38.6-88.3) versus 22.9% (7.1-38.7). Pooled Fixed effect of HR values (95% CI) for OS related to Caspase 3 IHC expression in HNC patients was 1.48 (95% CI 0.95-2.28); also, the rate of heterogeneity was low, as revealed by I = 31%. For DFS was 1.07 (95% CI 0.79-1.45) with I = 0% and DSS showed a HR of 0.88 (95% CI 0.69-1.12) with I = 37%. Caspase 3 and Cleaved Caspase 3 expression could be linked with malignancy progression, but the expression of Caspase 3 did not influence the prognosis of patients with HNC.
头颈部癌症（HNC）是一种上升和侵袭性疾病。为了解决诊断、风险管理、预后和治疗效果方面的困难，人们正在寻找新的分子标志物。与凋亡机制相关的蛋白质已被确定为潜在的生物标志物。Caspase 3 是主要的效应 Caspase，在凋亡中起关键作用。本系统评价和荟萃分析的目的是回顾分析 Caspase 3 和 Cleaved Caspase 3 表达在口腔癌前病变（OPMD）和头颈部癌症（HNC）中的变化的研究。本研究还提出根据 Caspase 3 的表达来回顾与 HNC 相关的预后价值。从成立到 2022 年 6 月，对 Medline（通过 PubMed）、EMBASE、Scopus、Cochrane、Web of Science 和灰色文献数据库进行了筛选，共选择了 18 项研究，其中 8 项纳入了预后荟萃分析。与 Caspase 3 表达比较相关的结果表明，HNC 中 Caspase 3 的表达相似，平均有 51.9%（9.5-98.1）显示高/中度表达，而 OPMD 为 45.7%（14.6-84.7）。有趣的是，与 OPMD 相比，HNC 中 Cleaved Caspase 3 的表达增加，为 73.3%（38.6-88.3），而 22.9%（7.1-38.7）。与 HNC 患者 Caspase 3 IHC 表达相关的 OS 的汇总固定效应 HR 值（95%CI）为 1.48（95%CI 0.95-2.28）；此外，异质性率较低，I = 31%。DFS 的 HR 值为 1.07（95%CI 0.79-1.45），I = 0%，DSS 显示 HR 为 0.88（95%CI 0.69-1.12），I = 37%。Caspase 3 和 Cleaved Caspase 3 的表达可能与恶性进展有关，但 Caspase 3 的表达并不影响 HNC 患者的预后。
