Wang Shuyu, Du Hongyang, Li Guixia
Medical Laboratory Department, Heze Municipal Hospital, Heze, Shandong, 274031 China.
Heze Centre for Adverse Drug Reactions Monitoring, Heze, Shangdong, 274000, China.
Oncotarget. 2017 Feb 28;8(9):15815-15826. doi: 10.18632/oncotarget.15012.
Esophageal cancer is the sixth leading cause of cancer death worldwide. Detection of circulating tumor cells (CTCs) is emerging as a novel strategy for predicting cancer patient prognosis. Here we performed a comprehensive literature search to identify relevant articles in EMbase, PubMed, EBSCO, OVID, Cochrane Database, CNKI, WanFangdata and VIPdata. Meta-analysis was conducted using Stata12.0 software, according to the inclusion and exclusion criteria, extracted data and assessment methodology. Thirteen eligible literature studies were included with a total of 979 esophageal squamous cell carcinoma patients, including 424 CTC-positive and 684 CTC-negative cases. Meta-analysis showed that the presence of CTCs was associated with both worse progression-free/disease-free survival [hazard ration (HR) = 2.32, 95% confidence interval (CI) = 1.57 - 3.43, p < 0.001] and poorer overall survival [HR = 2.64, 95% CI = 1.69 - 4.14, p < 0.001]. Further subgroup analyses demonstrated that CTC-positive patients also showed worse progression-free/disease-free survival and poorer overall survival in different subsets. In summary, our meta-analysis provides strong evidence that detection of CTCs in the peripheral blood is an independent prognostic indicator of poor outcome for esophageal squamous cell carcinoma patients.
食管癌是全球第六大癌症死亡原因。循环肿瘤细胞（CTC）检测正成为预测癌症患者预后的一种新策略。在此，我们进行了全面的文献检索，以在EMbase、PubMed、EBSCO、OVID、Cochrane数据库、中国知网、万方数据和维普数据中识别相关文章。根据纳入和排除标准、提取的数据及评估方法，使用Stata12.0软件进行荟萃分析。纳入了13项符合条件的文献研究，共979例食管鳞状细胞癌患者，其中424例CTC阳性，684例CTC阴性。荟萃分析表明，CTC的存在与无进展/无病生存期较差相关[风险比（HR）= 2.32，95%置信区间（CI）= 1.57 - 3.43，p < 0.001]，且与总生存期较差相关[HR = 2.64，95% CI = 1.69 - 4.14，p < 0.001]。进一步的亚组分析表明，在不同亚组中，CTC阳性患者的无进展/无病生存期也较差，总生存期也较差。总之，我们的荟萃分析提供了有力证据，表明外周血中CTC的检测是食管鳞状细胞癌患者预后不良的独立预后指标。
