Investigation of E-Cadherin level in patients with premalignant and malignant oral lesions: A systematic review

Abstract

Objective: Oral squamous cell carcinoma (OSCC) is the most common malignancy of the oral cavity and is the eighth most prevalent cancer worldwide. OSCC management is still strongly dependent on classical parameters like TNM stage and tumor grading, and novel biomarkers are urgently needed for earlier diagnosis and better survival. Epithelial cadherin (E-cadherin) is a calcium-dependent protein for cell–cell adhesion that holds the epithelial cells tight together. E-cadherin acts as a tumor invasion suppressor. Loss of function contributes to progression in cancer by increasing proliferation, invasion, and/or metastasis.If there is a significant difference in the levels of E-Cadherin in the two groups and it is possible to detect the progress of these lesions due to the level of this factor, it can be used for early diagnosis. This systematic review, reviewed the levels of E-cadherin in premalignant and malignant lesions of the oral cavity.

Materials and methods: A systematic literature search was performed in PubMed, Scopus, Web of science, EMBASE, Google Scholar. Preferred Reporting Items for Systematic Reviews guidelines were observed for article selection. The study selection process was performed in four steps according to the PRISMA flow diagram. Risk of bias was evaluated by the JBI checklist for case-control studies.

Results: A total of eight studies incorporating 346 patients with premalignant lesions and 353 patients with malignant lesions were involved. Due to the heterogeneity between the studies, meta-analysis was not possible. E-cadherin level in malignant lesions was lower compared to premalignant lesions except for one study.

Conclusion: Present study reviewed levels of E-cadherin in different premalignant and malignant lesions. It seems that as the premalignant lesion progresses toward malignancy the level of E-cadherin reduces. However, given the limited number of the included studies, further studies are needed for warranted results that determine if this measurement could be used for diagnosis of malignancy state or if it will improve the prognosis or not.