Mismatch repair protein expression as a prognostic factor in head and neck squamous cell carcinoma: A systematic review.
José Renato de Carvalho Gomes, Raisa Ferreira Costa, Reydson Alcides de Lima-Souza et al.
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In 30 seconds
This systematic review assessed whether mismatch repair (MMR) protein expression predicts outcomes in patients with head and neck squamous cell carcinoma (HNSCC). Seven observational studies involving 846 patients were qualitatively synthesized; heterogeneity precluded meta-analysis. Across studies, MutSα overexpression or low/absent MSH2 expression was consistently associated with poorer overall survival, with reported hazard ratios ranging from 2.75 to 4.38. Findings for MLH1, MSH6, and PMS2 were inconsistent and varied by tumor subsite, HPV/p16 status, and age. The authors identify MSH2 as a promising prognostic marker requiring further validation.
Key findings
- Seven observational studies involving 846 HNSCC patients met the review criteria; methodological differences prevented quantitative pooling.
- MutSα overexpression or low/absent MSH2 expression was associated with poorer overall survival, with reported hazard ratios ranging from 2.75 to 4.38.
- Prognostic findings for MLH1, MSH6, and PMS2 varied by tumor subsite, HPV/p16 status, and patient age.
Why it matters
MMR protein expression may help refine prognostic assessment in HNSCC, but the evidence is not equally consistent across markers. The recurring association between altered MSH2 expression and poorer survival makes it a candidate for further study, while variation across tumor and patient characteristics cautions against treating MMR markers as interchangeable or established prognostic tools.
What to keep in mind
Only seven observational studies were available, and their methods and findings were too heterogeneous for meta-analysis. The prognostic value of several MMR proteins was inconsistent.