University of Oulu

Elseragy, A, Bello, IO, Wahab, A, et al. Emerging histopathologic markers in early-stage oral tongue cancer: A systematic review and meta-analysis. Head & Neck. 2022; 44( 6): 1481- 1491. doi:10.1002/hed.27022

Emerging histopathologic markers in early-stage oral tongue cancer : a systematic review and meta-analysis

Saved in:
Author: Elseragy, Amr1,2,3; Bello, Ibrahim O.3,4; Wahab, Awais2,3;
Organizations: 1Cancer and Translational Medicine Research Unit, Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
2Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
3Department of Pathology, University of Helsinki, Helsinki, Finland
4Department of Oral Medicine and Diagnostic Sciences, King Saud University College of Dentistry, Riyadh, Saudi Arabia
5Department of Oral Diagnosis, School of Dentistry, University of Campinas, Piracicaba, São Paulo, Brazil
6Graduate Program in Oral Biology, School of Dentistry, University of Campinas, Piracicaba, São Paulo, Brazil
7Department of Otorhinolaryngology – Head and Neck Surgery, University of Helsinki and HUS Helsinki University Hospital, Helsinki, Finland
8Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
9Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
10Institute of Biomedicine, Pathology, University of Turku, Turku, Finland
11Turku University Central Hospital, Turku, Finland
12Faculty of Dentistry, Misurata University, Misurata, Libya
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 5.6 MB)
Persistent link:
Language: English
Published: John Wiley & Sons, 2022
Publish Date: 2022-09-09


Although there are many histopathologic prognosticators, grading of early oral tongue squamous cell carcinoma (OTSCC) is still based on morphological cell differentiation which has low prognostic value. Here we summarize the emerging histopathological markers showing powerful prognostic value, but are not included in pathology reports. Using PubMed, Scopus, Ovid Medline, and Web of Science databases, a systematic literature search was preformed to identify early OTSCC studies that investigated the prognostic significance of hematoxylin–eosin-based histopathologic markers. Our meta-analysis showed that tumor budding was associated with overall survival (hazard ratio [HR] 2.32; 95% CI 1.40–3.84; p < 0.01) and disease-specific survival (DSS) (1.89; 95% CI 1.13–3.15; p = 0.02). Worst pattern of invasion was associated with disease-free survival (DFS) (1.95; 95% CI 1.04–3.64; p = 0.04). Tumor–stroma ratio was also associated with DFS (1.75, 95% CI 1.24–2.48; p < 0.01) and DSS (1.69; 95% CI 1.19–2.42; p < 0.01). Tumor budding, worst pattern of invasion, and tumor–stroma ratio have a promising prognostic value in early OTSCC. The evaluation and reporting of these markers is cost-effective and can be incorporated in daily practice.

see all

Series: Head & neck
ISSN: 1043-3074
ISSN-E: 1097-0347
ISSN-L: 1043-3074
Volume: 44
Issue: 6
Pages: 1481 - 1491
DOI: 10.1002/hed.27022
Type of Publication: A2 Review article in a scientific journal
Field of Science: 3122 Cancers
3111 Biomedicine
Funding: Cancer Society of Finland; Helsinki University Central Hospital; Jane and Aatos Erkko Foundation; Oulu University Hospital MRC; Sigrid Juselius Foundation.
Copyright information: © 2022 The Authors. Head & Neck published by Wiley Periodicals LLC. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.