What role do mucins have in the development of laryngeal squamous cell carcinoma? A systematic review.

Mucins are the dominant component in the protective mucus layer on mucosal surfaces including the larynx. Hence, they are part of the first line of defence against external stimuli including effect of smoking in the larynx. We asked whether existing published evidence supported the hypothesis that alteration in mucins expression/production is related to the laryngeal neoplastic process. The objective of this study is to review published evidence for mucins having an important role in normal laryngeal physiology and the development of laryngeal squamous cell carcinoma (SCC). We aimed to review all available literature on mucins in the larynx in order to develop hypotheses to be tested by future research. Thereby, new potential means of prevention and treatment of laryngeal cancer may be developed. A systematic search of all published literature was conducted. Systematic searches were done in the following databases: AMED, BNI, EMBASE, HMIC, MEDLINE, PsycINFO, CINAHL and HEALTH BUSINESS ELITE from their respective inception up to 11 February 2011. The following keywords were used in combination: mucin, larynx and squamous cell carcinoma. Altogether, 53 studies were identified; 43 studies were excluded following screening of the titles and abstracts. Full text manuscripts for ten studies were obtained for detailed evaluation and five studies were included in this review. No single study fulfilled all relevant criteria. Based on the included studies, we now know that MUC1 is definitely expressed in SCC larynx. However, there is no definitive evidence to suggest that MUC1 and MUC2 are aberrantly expressed in SCC larynx as compared to normal larynx. Further studies using the best available detection technique to detect MUC1, MUC2 and other possible relevant mucins i.e., MUC4 on adequate numbers of normal and SCC specimens are needed to confirm the findings of this review.