Department of Surgical Oncology and General Surgery, First Hospital of China Medical University, Heping District, Shenyang City, People's Republic of China.
Int J Cancer. 2015 Jan 1;136(1):21-33. doi: 10.1002/ijc.28954. Epub 2014 May 15.
The prognostic significance of circulating tumor cells (CTCs) and disseminated tumor cells (DTCs) in patients with gastric cancer (GC) is controversial. The aims of our meta-analysis are to assess its correlation with clinicopathological characteristics and prognostic significance in GC. PubMed, Embase, the Cochrane database, the Science citation index, the CNKI database and the references of relevant studies were systematically searched (up to November, 2013). Using the random-effect model, the meta-analysis was completed with odds ratio (OR), risk ratio, hazard ratio (HR) and 95% confidence intervals (CI) as effect values. Twenty-six studies containing 2,566 patients with GC were analyzed. The overall analysis showed that the incidence difference of tumor cells (CTCs/DTCs) was significant when comparing the stage I/II group to the stage III/IV group (OR = 0.36, CI [0.23, 0.56]), the Lauren diffuse group to the intestinal group (OR = 2.06, CI [1.06, 4.00]), the poorly differentiated group to the well/moderate group (OR = 1.65, CI [1.10, 2.50]), the lymphatic involvement positive group to the positive group (OR = 2.92, CI [1.00, 8.55]). The detection of CTCs/DTCs was significantly related with the disease-free survival of patients (HR = 3.42, CI [2.39, 4.91]) and the detection of CTCs in peripheral blood was significantly related with the overall survival of patients (HR = 2.13, CI [1.13, 4.03]). Our meta-analysis indicates that detection of CTCs/DTCs is associated with prognosis for patients with GC and thus could act as a basis for GC staging.
循环肿瘤细胞（CTCs）和播散肿瘤细胞（DTCs）在胃癌（GC）患者中的预后意义存在争议。本荟萃分析的目的是评估其与 GC 临床病理特征的相关性及其预后意义。系统检索了 PubMed、Embase、Cochrane 数据库、科学引文索引、中国知网（CNKI）数据库和相关研究的参考文献（截至 2013 年 11 月）。使用随机效应模型，以比值比（OR）、风险比（RR）、风险比（HR）和 95%置信区间（CI）作为效应值进行荟萃分析。分析了 26 项包含 2566 例 GC 患者的研究。总体分析显示，肿瘤细胞（CTCs/DTCs）的发生率在 I/II 期与 III/IV 期（OR=0.36，CI[0.23，0.56]）、弥漫型与肠型（OR=2.06，CI[1.06，4.00]）、低分化组与中高分化组（OR=1.65，CI[1.10，2.50]）、淋巴浸润阳性组与阳性组（OR=2.92，CI[1.00，8.55]）之间存在显著差异。CTCs/DTCs 的检测与患者的无病生存率（HR=3.42，CI[2.39，4.91]）显著相关，外周血中 CTCs 的检测与患者的总生存率（HR=2.13，CI[1.13，4.03]）显著相关。本荟萃分析表明，CTCs/DTCs 的检测与 GC 患者的预后相关，因此可以作为 GC 分期的基础。
