Circulating tumour cells predict survival in gastric cancer patients: a meta-analysis

Hui-yu Wang, Jia Wei, Z. Zou, X. Qian, Bao-rui Liu
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引用次数: 15

Abstract

Aim of the study The prognostic value of the detection of circulating tumour cells (CTCs) in gastric cancer has been studied intensely in recent years. However, the application of different technologies led to inconsistent results between the studies. Here, we performed a meta-analysis of published studies to summarise the evidence. Material and methods Medline and ISI Web of Knowledge were searched up to March 2013 using “circulating tumor cells” and “gastric cancer” as search terms. Hazard ratio (HR) with 95% confidence intervals (CIs) for prognostic outcomes and clinical characteristics were extracted from each study. Pooled hazard ratios (HR) and odds ratios (OR) were calculated using random or fixed-effects models. Results Twelve studies enrolling 774 patients were included. The combined HR estimate for overall survival (OS), disease-free survival (DFS), and progression-free survival (PFS) were 1.41 (95% CI: 1.28–1.62), 2.99 (95% CI: 2.01–4.45) and 1.64 (95% CI: 1.02–2.62), respectively. Subgroup analysis concerning detection methods and sampling time showed that results of RT-PCR for the OS group and RT-PCR for the DFS group suggest a prognostic significance of CTC detection (pooled HR [95% CI]: 1.45 [1.28–1.65], I2 = 38%, p = 0.13; 2.99 [2.01–4.45], I2 = 0%, p = 0.32). In addition, results of the baseline CTC detection group also indicated a significant prognostic value to predict OS and DFS (pooled HR [95% CI]: 1.47 [1.19–1.82], I2 = 38%, p = 0.14; 2.99 [2.01–4.45], I2 = 0%, p = 0.32). We simultaneously found that the detection of CTCs correlated with pathological stage (pooled OR [95% CI]: 2.95 [1.65–5.28], I2 = 56%, p = 0.03), lymph node status (pooled OR [95% CI]: 2.26 [1.50–3.41], I2 = 37%, p = 0.09), the depth of invasion (pooled OR [95% CI]: 3.21 [1.38–7.43], I2 = 72%, p = 0.002), and distant metastasis (pooled OR [95% CI]: 2.68 [1.25–5.73], I2 = 43%, p = 0.15). Conclusions Detection of CTCs is associated with poorer prognosis in gastric cancer patients.
循环肿瘤细胞预测胃癌患者的生存:一项荟萃分析
目的研究循环肿瘤细胞(CTCs)检测在胃癌预后中的价值,近年来得到了广泛的研究。然而,不同技术的应用导致研究结果不一致。在这里,我们对已发表的研究进行了荟萃分析,以总结证据。材料与方法以“循环肿瘤细胞”和“胃癌”为检索词,检索至2013年3月。从每项研究中提取预后结果和临床特征的风险比(HR)和95%可信区间(ci)。采用随机或固定效应模型计算合并风险比(HR)和优势比(OR)。结果纳入12项研究,共纳入774例患者。总生存期(OS)、无病生存期(DFS)和无进展生存期(PFS)的合并HR估计分别为1.41 (95% CI: 1.28-1.62)、2.99 (95% CI: 2.01-4.45)和1.64 (95% CI: 1.02-2.62)。关于检测方法和采样时间的亚组分析显示,OS组和DFS组的RT-PCR结果提示CTC检测具有预后意义(合并HR [95% CI]: 1.45 [1.28-1.65], I2 = 38%, p = 0.13;2.99 [2.01-4.45], I2 = 0%, p = 0.32)。此外,基线CTC检测组的结果对预测OS和DFS也有显著的预后价值(合并HR [95% CI]: 1.47 [1.19-1.82], I2 = 38%, p = 0.14;2.99 [2.01-4.45], I2 = 0%, p = 0.32)。我们同时发现,ctc的检测与病理分期(合并OR [95% CI]: 2.95 [1.65-5.28], I2 = 56%, p = 0.03)、淋巴结状态(合并OR [95% CI]: 2.26 [1.50-3.41], I2 = 37%, p = 0.09)、浸润深度(合并OR [95% CI]: 3.21 [1.38-7.43], I2 = 72%, p = 0.002)和远处转移(合并OR [95% CI]: 2.68 [1.25-5.73], I2 = 43%, p = 0.15)相关。结论胃癌患者ctc检测与预后不良相关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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