Fan Jun-Li, Yang Yi-Fei, Yuan Chun-Hui, Chen Hao, Wang Fu-Bing
Cell Physiol Biochem. 2015;37(2):629-40. doi: 10.1159/000430382.
BACKGROUND/AIMS: The prognostic value of circulating tumor cells (CTC) detected in hepatocellular carcinoma (HCC) patients is currently under debate. We conducted a meta-analysis of available studies to assess its prognostic value for patients diagnosed with HCC.
Medline, Ovid Database, Embase, The Science Citation Index, and Cochrane library, search was conducted on all studies reporting the outcomes of interest. The studies were set up according to the inclusion/exclusion criteria. Using a random-effects model, meta-analysis was performed using hazard ratio (HR), risk ratio (RR) and their 95% confidence intervals (95% CIs) as effect measures. Heterogeneity of the studies was tested for each pooled analysis. Subgroup and sensitivity analyses were also performed.
twenty-three published studies that matched the selection criteria were included in this meta-analysis. CTC positivity was significantly associated with Relapse free survival (RFS) (HR 3.03, 95% CI: [1.89-4.86]; p<0.00001) and Overall survival (OS) (HR 2.45, 95% CI: [1.73-3.48]; p<0.00001). CTC positivity were also significantly associated with TNM Stage (RR 1.30, 95% CI: [1.02-1.65]; p=0.03), Tumor size (RR 1.36, 95% CI: [1.09-1.69]; p=0.006), Vascular invasion (RR 1.99, 95% CI: [1.43-2.77]; p<0.0001), Portal vein tumor thrombus (RR 1.73, 95% CI: [1.42-2.11]; p=0.0001), Serum alpha-fetoprotein (AFP) level (RR 2.05, 95% CI: [1.18-3.54]; p=0.01).
CTC positivity indicates poor prognosis in patients with hepatocellular carcinoma, and associated with poor clinicopathologic parameters.
背景/目的：目前肝细胞癌（HCC）患者中检测到的循环肿瘤细胞（CTC）的预后价值存在争议。我们对现有研究进行了荟萃分析，以评估其对诊断为HCC患者的预后价值。
在Medline、Ovid数据库、Embase、科学引文索引和Cochrane图书馆中，对所有报告感兴趣结果的研究进行检索。根据纳入/排除标准设立研究。使用随机效应模型，以风险比（HR）、比值比（RR）及其95%置信区间（95%CI）作为效应量进行荟萃分析。对每项汇总分析进行研究异质性检验。还进行了亚组分析和敏感性分析。
本荟萃分析纳入了23项符合选择标准的已发表研究。CTC阳性与无复发生存期（RFS）显著相关（HR 3.03，95%CI：[1.89 - 4.86]；p<0.00001）和总生存期（OS）（HR 2.45，95%CI：[1.73 - 3.48]；p<0.00001）。CTC阳性还与TNM分期（RR 1.30，95%CI：[1.02 - 1.65]；p = 0.03）、肿瘤大小（RR 1.36，95%CI：[1.09 - 1.69]；p = 0.006）、血管侵犯（RR 1.99，95%CI：[1.43 - 2.77]；p<0.0001）、门静脉肿瘤血栓（RR 1.73，95%CI：[1.42 - 2.11]；p = 0.0001）、血清甲胎蛋白（AFP）水平（RR 2.05，95%CI：[1.18 - 3.54]；p = 0.01）显著相关。
CTC阳性表明肝细胞癌患者预后不良，并与不良的临床病理参数相关。
