Huang Xuanzhang, Gao Peng, Song Yongxi, Sun Jingxu, Chen Xiaowan, Zhao Junhua, Xu Huimian, Wang Zhenning
Department of Surgical Oncology and General Surgery, First Hospital of China Medical University, 155 North Nanjing Street, Heping District, 110001, Shenyang City, People's Republic of China.
BMC Cancer. 2015 Mar 30;15:202. doi: 10.1186/s12885-015-1218-9.
The prognostic value of circulating tumor cells (CTCs) detected with the CellSearch System in patients with colorectal cancer (CRC) is controversial. The aim of our meta-analysis was to evaluate whether the detection of CTCs in the peripheral blood with the standardized CellSearch System has prognostic utility for patients with CRC.
The PubMed, Science Citation Index, Cochrane Database, Embase, and the references in relevant studies were systematically searched (up to December, 2014). No search restrictions were imposed. Our meta-analysis was performed in Stata software, version 12.0 (2011) (Stata Corp, College Station, TX, USA), with the odds ratio (OR), risk ratio (RR), hazard ratio (HR), and 95% confidence interval (95% CI) as the effect measures. Subgroup and sensitivity analyses were also conducted.
Eleven studies containing 1847 patients with CRC were analyzed. There was a significantly higher incidence of CTCs in the metastasis-positive group than in the metastasis-negative group (OR = 4.06, 95% CI [1.74, 9.50], P < 0.01, I(2) = 0%). For hepatic metastasis, a type of metastasis, a higher incidence of CTCs was observed in the hepatic-metastasis-positive group than in the -negative group (OR = 2.61, 95% CI [1.73, 3.96], P < 0.01, I(2) = 0%). The presence of CTCs was significantly related to overall survival (HR = 2.00, 95% CI [1.49, 2.69], P < 0.01, I(2) = 67.1%) and progression-free survival (HR = 1.80, 95% CI [1.52, 2.13], P < 0.01, I(2) = 43.9%) of patients with CRC, regardless of the sampling time. The response rate for the CTC(+) groups was significantly lower than that for the CTC(-) groups at baseline and during treatment (baseline: 33% versus 39%, RR = 0.79, 95% CI [0.63, 0.99], P = 0.04, I(2) = 7.0%; during treatment: 17% versus 46%, RR = 0.41, 95% CI [0.22, 0.77], P = 0.01, I(2) = 0.0%;).
Our meta-analysis indicates that the detection of CTCs in the peripheral blood with the CellSearch System has prognostic utility for patients with CRC.
采用CellSearch系统检测循环肿瘤细胞（CTC）在结直肠癌（CRC）患者中的预后价值存在争议。我们进行这项荟萃分析的目的是评估使用标准化的CellSearch系统检测外周血中的CTC对CRC患者是否具有预后评估作用。
系统检索了PubMed、科学引文索引、Cochrane数据库、Embase以及相关研究中的参考文献（截至2014年12月）。未设置检索限制。我们在Stata软件12.0版（2011年）（美国德克萨斯州大学站市Stata公司）中进行荟萃分析，以比值比（OR）、风险比（RR）、风险比（HR）和95%置信区间（95%CI）作为效应量指标。同时进行了亚组分析和敏感性分析。
分析了11项研究，共纳入1847例CRC患者。转移阳性组中CTC的发生率显著高于转移阴性组（OR = 4.06，95%CI [1.74, 9.50]，P < 0.01，I² = 0%）。对于肝转移这一转移类型，肝转移阳性组中CTC的发生率高于阴性组（OR = 2.61，95%CI [1.73, 3.96]，P < 0.01，I² = 0%）。无论采样时间如何，CTC的存在与CRC患者的总生存期（HR = 2.00，95%CI [1.49, 2.69]，P < 0.01，I² = 67.1%）和无进展生存期（HR = 1.80，95%CI [1.52, 2.13]，P < 0.01，I² = 43.9%）显著相关。在基线期和治疗期间，CTC阳性组的缓解率显著低于CTC阴性组（基线期：33%对39%，RR = 0.79，95%CI [0.63, 0.99]，P = 0.04，I² = 7.0%；治疗期间：17%对46%，RR = 0.41，95%CI [0.22, 0.77]，P = 0.01，I² = 0.0%）。
我们的荟萃分析表明，使用CellSearch系统检测外周血中的CTC对CRC患者具有预后评估作用。
