High Expression of Bcl-2 Protein Predicts Favorable Outcome in Non-small Cell Lung Cancer: Evidence from a Systematic Review and Meta-analysis

  • Zhao, Xian-Da (Department of Pathology, School of Basic Medical Science, Wuhan University) ;
  • He, Yu-Yu (Department of Pathology, School of Basic Medical Science, Wuhan University) ;
  • Gao, Jun (Department of Molecular Pathology, Wuhan Nano Tumor Diagnosis Engineering Research Center) ;
  • Zhao, Chen (Department of Pathology, School of Basic Medical Science, Wuhan University) ;
  • Zhang, Ling-Lin (Department of Pathology, School of Basic Medical Science, Wuhan University) ;
  • Tian, Jing-Yuan (Department of Pathology, School of Basic Medical Science, Wuhan University) ;
  • Chen, Hong-Lei (Department of Pathology, School of Basic Medical Science, Wuhan University)
  • Published : 2014.11.06


Background: The prognostic value of Bcl-2 protein expression in non-small cell lung cancer (NSCLC) is under debate. We therefore systematically reviewed the evidence for Bcl-2 protein effects on NSCLC survival to elucidate this issue. Materials and Methods: An electronic search in Pubmed and Embase complemented by manual searches in article references were conducted to identify eligible studies to evaluate the association between Bcl-2 protein expression and overall survival (OS) as well as disease free survival (DFS) of NSCLC patients. Combined hazard ratios (HRs) with corresponding 95% confidence intervals (95%CIs) were pooled using the random-effects model. Results: A total of 50 trials (including 52 cohorts) encompassing 7,765 patients were pooled in the meta-analysis regarding Bcl-2 expression and OS of NSCLC patients. High expression of Bcl-2 protein had a favorable impact (HR=0.76, 95%CI=0.67-0.86). In the group of Bcl-2 expression and DFS, 11 studies including 2,634 patients were included. The synthesized result indicated high expression of Bcl-2 protein might predict good DFS (HR=0.85, 95%CI=0.75-0.95). Conclusions: Our present meta-analysis demonstrated favorable prognostic values of Bcl-2 expression in patients with NSCLC. Further prospective trails are welcomed to validate the utility of assessing Bcl-2 in NSCLC patient management.


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