Slivar Isabela de Sousa, Zanesco Bruno de Andrade, Martins Manoela Domingues, Matos Leandro Luongo, Nunes Fábio Daumas, Schuch Lauren Frenzel, Wagner Vivian Petersen
Department of Dentistry, School of Dentistry, Universidade de São Paulo (FOUSP), São Paulo, Brazil.
Department of Oral Diagnosis, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba (UNICAMP), São Paulo, Brazil.
J Oral Pathol Med. 2025 Sep;54(8):647-657. doi: 10.1111/jop.70028. Epub 2025 Aug 11.
Most studies suggest that NOTCH1 alterations are associated with prognosis in adenoid cystic carcinoma (ACC), but findings remain fragmented. We conducted an integrative analysis to evaluate the prognostic value of NOTCH1-related biomarkers in ACC.
A comprehensive search was conducted across multiple databases. Inclusion criteria comprised studies examining NOTCH1-related features at ACC diagnosis and their relation with survival outcomes. Meta-analysis was performed on studies sharing similar methodology.
Twelve studies met the eligibility criteria. NOTCH1 mutational status, Notch1 immunoexpression, and NICD1 immunoexpression were associated either with overall, disease-free or progression-free survival. Methodological disparities hindered integration of results. Meta-analyses of HRs were conducted with 2 studies for each index factor, revealing a 2.31-fold increased risk of death for primary ACC cases with NOTCH1 mutations, a 2.6-fold increased risk of death for those exhibiting positive NICD1 expression and a 1.91-fold heightened risk of disease recurrence for cases with high Notch1 expression.
This comprehensive review underscores the prognostic relevance of NOTCH1 in ACC, indicating its potential as a valuable risk stratification tool.