title: Clinicopathological and prognostic significance of survivin expression in patients with oral squamous cell carcinoma: evidence from a meta-analysis.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Peking University School and hospital of Stomatology, Beijing 100081, China.
authors.forename: Shang
authors.initials: S
authors.lastname: Xie
authors.affiliation: Department of Oral and Maxillofacial Surgery, Peking University School and hospital of Stomatology, Beijing 100081, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Xu
authors.affiliation: Department of Oral and Maxillofacial Surgery, Peking University School and hospital of Stomatology, Beijing 100081, China.
authors.forename: Xiaofeng
authors.initials: X
authors.lastname: Shan
authors.affiliation: Department of Oral and Maxillofacial Surgery, Peking University School and hospital of Stomatology, Beijing 100081, China.
authors.forename: Baozhong
authors.initials: B
authors.lastname: Liu
authors.affiliation: Department of Oral and Maxillofacial Surgery, Peking University School and hospital of Stomatology, Beijing 100081, China.
authors.forename: Kan
authors.initials: K
authors.lastname: Wang
authors.affiliation: Department of Oral and Maxillofacial Surgery, Peking University School and hospital of Stomatology, Beijing 100081, China.
authors.forename: Zhigang
authors.initials: Z
authors.lastname: Cai
mesh_terms: D014408:Biomarkers, Tumor / Q000235:genetics / Q000378:metabolism*; D002294:Carcinoma, Squamous Cell / Q000378:metabolism* / Q000473:pathology; D005260:Female; D006801:Humans; D051034:Inhibitor of Apoptosis Proteins / Q000235:genetics / Q000378:metabolism*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000378:metabolism* / Q000473:pathology; D000077022:Survivin
chemical_list: C107489:BIRC5 protein, human; D014408:Biomarkers, Tumor; D051034:Inhibitor of Apoptosis Proteins; D000077022:Survivin