miRNA for the assessment of lymph node metastasis in patients with oral squamous cell carcinoma: Systematic review and metanalysis

Background: miRNA is one of the advanced epigenetic molecular markers correlating with lymph node metastasis in patients with Oral squamous cell carcinoma (OSCC). Numerous published papers are showing correlation of miRNA with metastasis. There is a need to analyze and validate such correlation. Method: English language literature in major databases from the last 20 years was searched using controlled vocabulary and keywords. Strict inclusion and exclusion criteria were followed for selection of studies. The quality assessment was done as per the QUADAS tool 2 by three independent reviewers. The metanalysis was performed by using random effect model. Standardized mean difference (SMD) was considered as the effect measure. Statistical software used was STATA version 13.1. Results: With all inclusion and exclusion criteria, eight studies could qualify for metanalysis. The pooled estimate is found to be 0.13 (−0.35, 0.62), P =.585, which is statistically not significant. This indicates that there is a no significant difference in the fold change between metastasis and no metastasis groups. P-value of chi-square statistic for heterogeneity is <.001 (significant), and I-squared statistic is 87.2%, which indicates that heterogeneity is present to a considerable extent. Egger's test shows there is no publication bias involved (P =.819). Conclusion: The metanalysis showed no significant difference in the fold change of miRNA expression between metastasis and non-metastasis OSCC patients. Future studies can be directed to eliminate the heterogeneity among the studies noted in this analysis to confirm the role of miRNA for assessment of regional metastasis with special focus on tongue squamous cell carcinoma.