Zeng Liqiong, Liang XiaoLong, Liu Qin, Yang Zhu
*Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Chongqing Medical University; and †China Effective Health Care Network, School of Public Health and Management, Chongqing Medical University, Chongqing, People's Republic of China.
Int J Gynecol Cancer. 2017 Jul;27(6):1109-1117. doi: 10.1097/IGC.0000000000000459.
Studies have confirmed that patients with circulating tumor cells (CTCs) in their peripheral blood (PB) or disseminated tumor cells (DTCs) in bone marrow (BM) might have bad prognosis. In this paper, we discuss whether CTCs/DTCs would be an appropriate biomarker to predict the prognosis of ovarian cancer.
We systematically searched PubMed, EMBASE, Cochrane library, and Chinese National Knowledge Infrastructure to collect relevant studies published from the time the database were created to February 2014. Studies quality was assessed by Newcastle-Ottawa Scale. The effect size was estimated by hazard ratio (HR) and corresponding 95% confidence interval (95% CI). Meta-analysis was conducted with STATA Version 12.0.
Eight studies of 1184 patients were included in the final analysis. In the PB group, it showed that patients with positive CTCs had significantly shorter overall survival and disease-free survival than patients with negative CTCs (HR, 2.09; CI, 1.13-3.88 and HR, 1.72; CI, 1.32-2.25, respectively). The same result was shown with DTCs in the BM group (HR, 1.61; CI, 1.27-2.04 and HR, 1.44; CI, 1.15-1.80, respectively). We also discussed the influence of CTCs/DTCs on International Federation of Gynecology and Obstetrics stage, pathological grade with odds ratio and 95% CI. However, it did not show any statistical significance.
The CTCs/DTCs might be a new biomarker to predict the prognosis of ovarian cancer. Future studies are needed to confirm this consequence.
研究证实,外周血(PB)中存在循环肿瘤细胞(CTC)或骨髓(BM)中存在播散肿瘤细胞(DTC)的患者预后可能较差。在本文中,我们探讨CTC/DTC是否为预测卵巢癌预后的合适生物标志物。
我们系统检索了PubMed、EMBASE、Cochrane图书馆和中国知网,以收集从数据库创建至2014年2月发表的相关研究。采用纽卡斯尔-渥太华量表评估研究质量。效应大小通过风险比(HR)及相应的95%置信区间(95%CI)进行估计。使用STATA 12.0软件进行荟萃分析。
最终分析纳入了8项研究共1184例患者。在PB组中,结果显示CTC阳性患者的总生存期和无病生存期显著短于CTC阴性患者(HR分别为2.09;CI为1.13 - 3.88和HR为1.72;CI为1.32 - 2.25)。BM组中DTC的结果相同(HR分别为1.61;CI为1.27 - 2.04和HR为1.44;CI为1.15 - 1.80)。我们还通过比值比及95%CI探讨了CTC/DTC对国际妇产科联盟分期、病理分级的影响。然而,未显示出任何统计学意义。
CTC/DTC可能是预测卵巢癌预后的一种新生物标志物。需要进一步的研究来证实这一结果。