Immunohistochemical expression of p53/TP53 in histologically negative mucosal margins of head and neck squamous cell carcinomas and usefulness in predicting locoregional recurrence: A systematic review and meta-analysis

Objective

To compare the expression of p53/TP53 in histologically negative mucosal margins of head and neck squamous cell carcinoma with locoregional recurrence.

Design

A complete search through MEDLINE by PubMed, Google Scholar, Scopus and EMBASE until 31st January 2023, without period restriction. Articles on head and neck squamous cell carcinoma and p53/TP53 expression were included. Sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratio, Odds and relative risk ratio of p53/TP53 in histologically negative surgical margins and its effectiveness in predicting recurrences were derived and subjected to meta-analysis using Open Meta analyst for Sierra (10.12) software.

Results

The specificity of p53 immunohistochemistry in predicting locoregional recurrence was 0.844 (95 % CI:0.78 ± 0.89) (p-value- < 0.001) with a negative likelihood ratio of 0.487 (95 % CI: 0.35 ± 0.67) (p-value < 0.001) and positive likelihood ratio of 3.032 (95 % CI: 2.17 ± 4.22) (p-value < 0.001). The relative risk of locoregional recurrence in the histologically negative surgical margin with p53 positivity was 3.13 with statistical significance (Odds ratio: 5.249, CI:3.176 ± 8.676, p-value < 0.001). Subgroup meta-analysis based on the location of head and neck SCC shows significant prediction for recurrence in p53 positive margins with more significant results in laryngeal carcinoma recurrence (p value < 0.001) (overall p value < 0.000).

Conclusions

Immunohistochemical expression of p53 in histologically negative surgical margins of head and neck squamous cell carcinoma is a significant predictor of locoregional recurrence and prognosis.