The effects of proliferating cell nuclear antigen and p53 in patients with oral squamous cell carcinoma: a systematic review and meta-analysis

BACKGROUND: To evaluate the effect of proliferating cell nuclear antigen (PCNA) and p53 in patients with oral squamous cell carcinoma (OSCC). METHODS: Multiple databases, including PubMed, Embase, Cochrane library, and China National Knowledge Database, were searched for relevant studies and full-text articles that evaluated the effect of PCNA and p53 in patients with OSCC. Review Manager 5.2 was adopted to estimate the impact of the results among the selected articles. Forest plots, NOS table, sensitivity analysis, and bias analysis were also conducted. RESULTS: In total, nine eligible studies satisfied the included criteria. High PCNA expression (>50%) was significantly more prevalent in OSCC than low PCNA expression (<50%) (OR =3.88; 95% CI: 2.04–7.37; P<0.0001; I(2)=0%). However, there was no significant difference between p53 and OSCC (OR =1.60; 95% CI: 0.18–14.63; P=0.68; I(2)=86%). Low PCNA expression had a higher 5-year overall survival in OSCC patients than high PCNA expression (OR =0.47; 95% CI: 0.27–0.80; P=0.005; I(2)=41%). Meanwhile, p53 negative had a higher 5-year overall survival than p53 positive (OR =0.20; 95% CI: 0.10–0.42; P<0.0001; I(2)=0%). There was no difference between high and low PCNA in terms of metastasis (OR =0.80 with 95% CI: 0.18–3.45, I(2)=63%, P of over effect =0.76). The overall results showed no difference between p53 and metastasis (OR =0.38 with 95% CI: 0.13–1.10, I(2)=0%, P of over effect =0.07). DISCUSSION: PCNA and p53 might be suitable for prognostic and survival evaluation in OSCC patients.