To evaluate an association between prognostic significance of Moesin with histopathological grading of oral squamous cell carcinoma: A systematic review

PURPOSE: The aim of the present Aetiology/Risk type and Prognostic type of systematic review is to evaluate the value of Moesin as a biomarker of invasiveness in Oral Squamous Cell Carcinoma patients and to review/assess the available evidence regarding the prospective prognostic association between Moesin and histopathological grading of OSCC to enhance the quality of life and survival rate of oral cancer patients. METHOD: A systematic wide-range literature search was performed by authors (BS, KS, and DK) till October 2022 using both, electronic search media and manual search by hand, searching appropriate journals as per the focussed guiding question and inclusion/exclusion criteria. Major databases such as Scopus, EMBASE, Web of Science, Cochrane central register for controlled trials, PubMed & Google Scholar were conducted by two calibrated reviewers independently to gauge the association between the prognostic significance of Moesin with histopathological grading of oral squamous cell carcinoma. As this study is based on tissue samples of oral squamous cell carcinoma patients, all the selected studies were mostly, cross-sectional studies, and retrospective in nature. The studies were integrated with this review to gauge the association between the prognostic significance of Moesin with histopathological grading of oral squamous cell carcinoma (OSCC). The review included a total of 7 studies with tissue samples of 645 cases. The prime outcome was to assess the immunoexpression of Moesin among the different histopathological grades i.e well-differentiated SCC, moderately differentiated SCC, and poorly differentiated SCC and the subordinate outcome was to consider the extent of strong immunoexpression characteristics (cytoplasmic, membranous and mixed type) in different grades of OSCC as well as to correlate with morbidity, mortality, and/or 5 years or 10 years survival rate. RESULTS: The results were analyzed and presented narratively using the Critical Appraisal Tools developed by the University Of Oxford; Risk of Bias - Cochrane Risk of Bias tool - RoB 2.0, and GRADE-pro (Grading of Recommendations, Assessment, Development, and Evaluations) which rates the features of the evidence as high, moderate, low and very low. The risk of mortality expressed in terms of Hazard ratio has been elicited as a 1.37 times higher rate of mortality in the advanced histopathological stages of the OSCC cases. As the sample size of this review was insignificant, therefore, the authors have incorporated hazard ratios of some other studies of carcinomas in diverse sites in the body to give a flavor of prognostic outcomes of Moesin. It was observed that Moesin expression in Breast cancer and UADT carcinomas have a higher mortality rate as compared to OSCC and lung carcinoma cases and this decree strengthens our conviction that Moesin expression in the cytoplasm of advanced histopathological stages of cancer can be assumed as a sign of poor prognosis in all carcinomas including OSCC patients. CONCLUSION: A sample of seven studies is inadequate as definite evidence for claiming that Moesin is a strong biomarker of invasiveness in OSCC cases and more clinical trials need to be conducted on the prognostic efficacy of Moesin expression in the various histopathological grades of OSCC cases.