Diagnostic and prognostic value of Bcl-2 in uterine leiomyosarcoma

Author:

Travaglino Antonio,Raffone AntonioORCID,Raimondo Diego,Gencarelli Annarita,Esposito Italia,Gallo Cinzia,Improda Francesco Paolo,Vitale Salvatore Giovanni,Mollo Antonio,Casadio Paolo,Seracchioli Renato,Zullo Fulvio,Insabato Luigi

Abstract

Abstract Background Uterine leiomyosarcoma (uLMS) may show loss of expression of B-cell lymphoma-2 (Bcl-2) protein. It has been suggested that Bcl-2 loss may both be a diagnostic marker and an unfavorable prognostic marker in uLMS. Objective To define the diagnostic and prognostic value of Bcl-2 loss in uLMS through a systematic review and meta-analysis. Methods Electronic databases were searched from their inception to May 2020 for all studies assessing the diagnostic and prognostic value of Bcl-2 loss of immunohistochemical expression in uLMS. Data were extracted to calculate odds ratio (OR) for the association of Bcl-2 with uLMS vs leiomyoma variants and smooth-muscle tumors of uncertain malignant potential (STUMP), and hazard ratio (HR) for overall survival; a p value < 0.05 was considered significant. Results Eight studies with 388 patients were included. Loss of Bcl-2 expression in uLMS was not significantly associated with a diagnosis of uLMS vs leiomyoma variants and STUMP (OR = 2.981; p = 0.48). Bcl-2 loss was significantly associated with shorter overall survival in uLMS (HR = 3.722; p = 0.006). High statistical heterogeneity was observed in both analyses. Conclusion Loss of Bcl-2 expression appears as a significant prognostic but not diagnostic marker in uLMS. The high heterogeneity observed highlights the need for further research and larger studies.

Publisher

Springer Science and Business Media LLC

Subject

Obstetrics and Gynecology,General Medicine

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