Clinicopathological and Prognostic Significance of Survivin Expression in Patients with Oral Squamous Cell Carcinoma: Evidence from a Meta-Analysis

BACKGROUND Survivin has been proposed as a promising prognostic marker in oral squamous cell carcinoma (OSCC), but the published data on survivin expression in patients with this condition are controversial. To address this we performed a meta-analysis systematically to assess the clinicopathological and prognostic significance of survivin expression in OSCC. METHODS We searched PubMed, Embase, Web of Science and Ovid databases for papers investigating the clinicopathological and prognostic significance of survivin expression in OSCC. The pooled odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were used to determine the relevance of survivin. RESULTS A total of 15 papers, including 1040 cases in which survivin expression was detected by immunohistochemistry (IHC) or reverse transcription polymerase chain reaction (RT-PCR), were included. A meta-analysis of clinicopathological variables revealed a correlation between survivin expression and lymph node metastasis (OR = 0.62, 95% CI = 0.44-0.88, p < 0.05) and clinical stage (OR = 0.63, 95% CI = 0.41-0.96, p < 0.05). However, no significant associations were found between survivin expression and tumor differentiation grade (OR = 0.72, 95%CI = 0.26-1.11, p > 0.05), depth of invasion (OR = 0.76, 95% CI = 0.50-1.14, p > 0.05), age (OR = 0.78, 95% CI = 0.48-1.29, p > 0.05) or gender (OR = 1.31, 95% CI = 0.86-2.01, p > 0.05). Subgroup analysis using stratified detection methods showed no significant associations between the expression of survivin protein and clinicopathological variables in OSCC. A correlation between survivin expression and poor prognosis of patients with OSCC (HR = 1.62, 95% CI = 1.23-2.01, p < 0.05) was demonstrated. CONCLUSION Survivin is a potential prognostic marker of OSCC. Future studies with larger sample sizes and well-designed inclusion criteria will be needed to dissect the role of survivin expression in determining the clinicopathological features and/or prognosis of OSCC.