Almangush Alhadi, Alabi Rasheed Omobolaji, Pirinen Matti, Mäkitie Antti, Leivo Ilmo
Department of Pathology, University of Helsinki, Haartmaninkatu 3, Helsinki, FIN-00014, P.O. Box 21, Finland.
Institute of Biomedicine, Pathology, University of Turku, Kiinamyllynkatu 10 D 5035, Turku, 20520, Finland.
BMC Cancer. 2024 Dec 18;24(1):1517. doi: 10.1186/s12885-024-13317-z.
Many histopathologic prognostic markers, identified by routine hematoxylin and eosin (HE) staining, have been proposed for predicting the survival of patients with oral squamous cell carcinoma (OSCC). Subsequently, several meta-analyses have been conducted on these prognostic markers. We sought to analyze the accumulated evidence from these meta-analyses.
An electronic database search of PubMed, Scopus, Ovid Medline, Web of Science, and Cochrane Library was conducted to retrieve all meta-analysis articles published on histopathologic prognostic markers of OSCC. The risk of bias of the included studies was analyzed using the Risk of Bias in Systematic Reviews (ROBIS) tool. The synthesis of the results was conducted following the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).
There were 16 meta-analysis articles published on the histological prognostic markers of OSSC. The accumulated evidence from these meta-analyses highlighted the powerful prognostic value of depth of invasion, tumor thickness, perineural invasion, lymphovascular invasion, worst pattern of invasion, tumor budding, and tumor-stroma ratio. The highest odds ratio (OR) of a relationship between a histopathologic prognostic marker and outcome was for the depth of invasion (OR 10.16, 95% CI 5.05-20.46) and tumor thickness (OR 7.32, 95% CI 5.3-10.1) in predicting lymph node metastasis.
The published meta-analyses present robust evidence on the significance of emerging histopathologic markers, namely, worst pattern of invasion, tumor budding, and tumor-stroma ratio. It is time to consider such markers in daily pathology reporting and risk stratification of OSCC.
许多通过常规苏木精和伊红（HE）染色确定的组织病理学预后标志物已被提出用于预测口腔鳞状细胞癌（OSCC）患者的生存情况。随后，针对这些预后标志物进行了多项荟萃分析。我们试图分析这些荟萃分析中积累的证据。
对PubMed、Scopus、Ovid Medline、Web of Science和Cochrane图书馆进行电子数据库检索，以检索所有发表的关于OSCC组织病理学预后标志物的荟萃分析文章。使用系统评价中的偏倚风险（ROBIS）工具分析纳入研究的偏倚风险。结果的综合按照系统评价和荟萃分析的首选报告项目（PRISMA）指南进行。
有16篇关于OSSC组织学预后标志物的荟萃分析文章。这些荟萃分析积累的证据突出了浸润深度、肿瘤厚度、神经周围浸润、淋巴管浸润、最差浸润模式、肿瘤芽生和肿瘤-间质比的强大预后价值。在预测淋巴结转移方面，组织病理学预后标志物与结局之间关系的最高优势比（OR）是浸润深度（OR 10.16，95%CI 5.05-20.46）和肿瘤厚度（OR 7.32，95%CI 5.3-10.1）。
已发表的荟萃分析提供了有力证据，证明了新出现的组织病理学标志物，即最差浸润模式、肿瘤芽生和肿瘤-间质比的重要性。现在是时候在日常病理报告和OSCC的风险分层中考虑这些标志物了。
