Diagnostic and prognostic value of Bcl-2 in uterine leiomyosarcoma.
- Resource Type
- Article
- Authors
- Travaglino, Antonio; Raffone, Antonio; Raimondo, Diego; Gencarelli, Annarita; Esposito, Italia; Gallo, Cinzia; Improda, Francesco Paolo; Vitale, Salvatore Giovanni; Mollo, Antonio; Casadio, Paolo; Seracchioli, Renato; Zullo, Fulvio; Insabato, Luigi
- Source
- Archives of Gynecology & Obstetrics. Feb2023, Vol. 307 Issue 2, p379-386. 8p.
- Subject
- *PROGNOSIS
*LEIOMYOSARCOMA
*OVERALL survival
*UTERINE fibroids
*ODDS ratio
- Language
- ISSN
- 0932-0067
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. [ABSTRACT FROM AUTHOR]