Prognostic and clinical implications of c-erbB-2 expression in patients with oral cancer: A meta-analysis

BACKGROUND: Recently, many studies have suggested that the aberrant expression of c-erbB-2 existed in oral cancer (OC) patients and had a correlation with poor clinical features across OC patients. Considering the inconsistent results among published articles, we performed the meta-analysis to assess the prognostic and clinical effect of c-erbB-2 expression on oral tumors. METHODS: Web of Science, Embase, and PubMed were retrieved to acquire relevant publications based on selection criteria, up to February 8, 2020. Pooled odds ratios (OR) and hazard ratios (HR) with 95% confidence intervals (CI) were applied to evaluate the associations between c-erbB-2 expression and overall survival (OS), disease specific survival, disease-free survival as well as clinicopathology of OC. RESULTS: A total of 30 literatures with 1499 patients for survival of OC were enrolled in this meta-analysis. The results indicated that c-erbB-2 overexpression was significantly associated with poor OS (HR = 2.40, 95% CI = 1.53–2.55, P < .05), disease specific survival (HR = 2.60, 95% CI = 1.11–4.10, P < .05) and disease-free survival (HR = 2.22, 95% CI = 1.46–2.99, P < .05). Subgroup analysis based on race showed that the significant prognostic value of c-erbB-2 in OC was found both in Caucasians and Asians (OS of Caucasians, HR = 2.90, 95% CI = 1.50–4.31, P < .05; OS of Asians, HR = 1.90, 95% CI = 1.27–2.53, P < .05). Moreover, OC patients with enhanced c-erbB-2 expression were prone to male (OR = 1.97, 95% CI = 1.22–3.19, P < .05), advanced TNM stage (OR = 1.84, 95% CI = 1.17–2.88, P < .05), lymph node metastasis (OR = 2.23, 95% CI = 1.47–3.36, P < .05) and advanced grade (OR = 1.98, 95% CI = 1.30–3.01, P < .05), but not associated with distant metastasis (OR = 1.65, 95% CI = 0.98–3.04, P > .05). CONCLUSIONS: c-erbB-2 may be a potential indicator in the prediction of prognosis and clinicopathological features in OC patients.