Screening of oral squamous cell carcinoma by serum changes: A systematic review and meta‑analysis

Forooz Keshani, Saeedeh Khalesi, Alireza Aghaz, Mohammadreza Farhang, Nabiollah Akbari


Background: Oral squamous cell carcinoma (OSCC) is the sixth common cancer in the world
and 90% of oral malignant tumors. The aim of this study was the investigation of changes in some
metabolic elements of OSCC patients’ serum.
Materials and Methods: In this study, international databases such as PubMed, Science Direct, Scopus, Web of
Science, and National (Magiran, IranMedex) were searched from 1980 to 2019. To analyze the data,
a random‑effects model was used to combine the differences in the mean of studies in STATA
Software (version 12).
Results: A total of 724 articles were found with initial searching that 474 duplicate articles, 228
articles were excluded by reviewing the title and abstracts, and 17 articles were excluded from
the study due to lack of inclusion criteria. Finally, five articles entered the meta‑analysis phase. The
mean difference value for zinc concentration of blood serum was 2.01 (95% confidence interval (CI):
0.36–3.66) and for copper was 1.04 (95% CI: 0.01–2.07). In both populations, the heterogeneity
was found between studies (I2 = 97.4, P < 0.001).
Conclusion: Probably higher serum levels of copper and zinc could be one way to help to do aprimary screening of OSCC in suspected patients.
Key Words: Elements, meta‑analysis, mouth neoplasms, serum, squamous cell carcinoma


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