| Purpose:Many epidemiological studies have reported an association between periodontal disease and the risk of head and neck squamous cell carcinoma.However,the results of these studies have been inconsistent.Narrative synthesis and meta-analysis was performed to evaluate the correlation between periodontal disease and head and neck squamous cell carcinoma,in order to provide a new perspective and basis for the treatment of periodontal disease and head and neck squamous cell carcinoma.Method:Firstly,PubMed,Cochrane Library,Web of Science,Embase,CNKI,Wan fang,and China Biology Medicine disc were searched for papers published up to December 2021.According to the inclusion criteria,the retrieved articles were screened and excluded by two researchers independently,and the final inclusion was decided by discussion.Next,Quality assessment was performed according to the type of articles included in the studies.A narrative synthesis of the included studies was performed.Meta-analysis were then performed using revman5.3.1 software for studies using objective periodontal detection indexes to diagnose and evaluate periodontal disease.Subgroup analyses and meta-regression was performed to assess sources of heterogeneity.Sensitivity analysis was conducted to determine whether the results were reliable.Finally,Funnel plots were used to detect publication bias.Besides,Begg’s rank correlation test and Egger’s funnel plot symmetry test were used to detect the symmetry of funnel plots.In addition,this study used cumulative meta-analysis to test the stability of results in sequential order of publication year.Result:13 eligible observational studies were screened from 1488 articles,including 12 casecontrol studies and 1 cross-sectional study.A narrative synthesis of these 13 literatures was conducted,and a quantitative meta-analysis was performed on 8 literatures which used objective means to diagnose periodontal disease.The results of the meta-analysis showed that the risk of head and neck squamous cell carcinoma was 3.48 times higher in patients with periodontal disease than in people without periodontal disease(OR,3.48;95%CI,2.88-4.22;I2,28%).Overall heterogeneity was significantly reduced when the studies were grouped by region,but the results of metaregression showed that none of the grouping factors was a source of heterogeneity.Sensitivity analysis showed that the results of the meta-analysis were reliable.In addition,no publication bias was found,and cumulative meta-analyses in sequential order of publication year showed that the results tended to stabilize.Conclusion:Periodontal disease is an independent risk marker and a putative risk factor for head and neck squamous cell carcinoma. |
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