Preliminary evidence of helicobacter pylori in oral squamous cell carcinoma and oral premalignant disorders: A meta-analysis highlighting tissue associations

Abstract

Introduction

Oral squamous cell carcinoma (OSCC) is the most common head and neck cancer, linked to tobacco, alcohol, and HPV. The bacterium Helicobacter pylori (H. pylori), associated with gastrointestinal cancers, may also play a role in OSCC and oral premalignant disorders (OPMDs). This meta-analysis examines the potential association between H. pylori, OSCC, and its precursor lesions.

Methodology

Following PRISMA guidelines, databases were searched until July 30, 2024. Eligible studies focused on OSCC, OPMDs, and H. pylori. Data on study characteristics and detection methods were extracted. Bias was evaluated using the New Castle Ottawa Scale. Statistical analysis utilized a random-effects model in RevMan, reporting odds ratios (OR) and 95 % confidence intervals (CI). Heterogeneity was assessed with I².

Results

Twenty-three studies were included. Pooled estimates showed significantly more patients with OSCC and oral lichen planus (OLP) tested positive for H. pylori, with estimates of 0.17 [0.03, 0.31] and 0.19 [0.04, 0.34], respectively. Tissue sample studies indicated a significant association between H. pylori and OSCC (5.57 [3.23, 9.60]). However, data from other sample types were insufficient for pooled estimates.

Conclusion

This meta-analysis provides preliminary evidence of H. pylori's role in OSCC and OPMDs, suggesting its potential as a biomarker for early detection. Significant research gaps remain in H. pylori detection across various sample types, emphasizing the need for further studies, especially regarding non-invasive screening methods like saliva analysis.