Wang Shuyi, Zheng Gang, Cheng Boran, Chen Fangfang, Wang Zhenmeng, Chen Yuanyuan, Wang You, Xiong Bin
Department of Oncology, Zhongnan Hospital of Wuhan University, Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Wuhan, Hubei, P. R. China.
Department of General Surgery, The 5th Hospital of Wuhan, Wuhan, Hubei, P. R. China.
PLoS One. 2014 Jun 5;9(6):e99259. doi: 10.1371/journal.pone.0099259. eCollection 2014.
The prognostic significance of circulating tumor cells (CTCs) is controversial in gastric cancer (GC). We performed a meta-analysis of available studies to assess its prognostic value detected by RT-PCR for patients diagnosed with GC.
EMBase, PubMed, Ovid, Web of Science, Cochrane library and Google Scholar database search was conducted on all studies reporting the outcomes of interest. The studies were set up according to the inclusion/exclusion criteria. Meta-analysis was performed by using a random-effects model; hazard ratio (HR), risk ratio (RR) and their 95% confidence intervals (95% CIs) were set as effect measures. The information about trial design, results from the data was independently extracted. Heterogeneity of the studies was tested for each pooled analysis.
Nineteen studies published matched the selection criteria and were included in this meta-analysis. CTCs positivity was significantly associated with poor relapse free survival (RFS) (HR 2.42, 95% CI: [1.94-3.02]; P<0.001) and poor overall survival (OS) (HR 2.42, 95% CI: [1.94-3.02]; P<0.001). CTCs positivity were also significantly associated with regional lymph nodes (RLNs) metastasis (RR 1.42, 95% CI: [1.20-1.68]; p<0.0001), depth of infiltration (RR 1.51, 95% CI: [1.27-1.79]; p<0.0001), vascular invasion (RR = 1.43, 95% CI: [1.18-1.74], p = 0.0002) and TNM stage(I,II versus III) (RR 0.63, 95% CI [0.48-0.84]; p = 0.001).
Preoperative CTCs positivity indicates poor prognosis in patients with gastric cancer, and associated with poor clinicopathological prognostic factors.
循环肿瘤细胞（CTCs）在胃癌（GC）中的预后意义存在争议。我们对现有研究进行了荟萃分析，以评估通过逆转录聚合酶链反应（RT-PCR）检测到的CTCs对胃癌患者的预后价值。
在EMBase、PubMed、Ovid、Web of Science、Cochrane图书馆和谷歌学术数据库中检索所有报告感兴趣结果的研究。根据纳入/排除标准筛选研究。采用随机效应模型进行荟萃分析；将风险比（HR）、比值比（RR）及其95%置信区间（95%CI）作为效应量。独立提取试验设计信息和数据结果。对每项汇总分析进行研究异质性检验。
19项发表的研究符合选择标准，纳入本荟萃分析。CTCs阳性与无复发生存期（RFS）差（HR 2.42，95%CI：[1.94 - 3.02]；P < 0.001）和总生存期（OS）差（HR 2.42，95%CI：[1.94 - 3.02]；P < 0.001）显著相关。CTCs阳性还与区域淋巴结（RLNs）转移（RR 1.42，95%CI：[1.
