Sun Taojiao, Zou Kun, Yuan Zewei, Yang Chaogang, Lin Xiaobin, Xiong Bin
Department of Dental.
Department of Oncology, Zhongnan Hospital of Wuhan University, Hubei Key of Laboratory of Tumor Biological Behaviors and Hubei Cancer Clinical Study Center.
Onco Targets Ther. 2017 Aug 4;10:3907-3916. doi: 10.2147/OTT.S136530. eCollection 2017.
Many studies have assessed the clinical use of circulating tumor cells (CTCs) in head and neck cancer, but the clinicopathological and prognostic significance of CTCs is still unclear.
Two authors systematically searched the studies independently with keywords in PubMed, MEDLINE, EMBASE, Science Citation Index Expanded and Cochrane Library (from inception to February 2017). The estimated hazard ratio (HR), risk ratio (RR) and their 95% confidence intervals (95% CIs) were set as effect measures. All analyses were performed by STATA 12.0.
A total of 17 studies were included in this meta-analysis. Positive CTCs were significantly associated with poor overall survival (HR =2.80, 95% CI: 1.34-5.86), disease-free survival (HR =3.86, 95% CI: 2.03-7.36) and progression-free survival (HR =3.31, 95% CI: 1.71-6.42). CTC-positive patients tend to have higher recurrence (RR =2.13, 95% CI: 1.26-3.59) and regional lymph node metastasis (RR =1.18, 95% CI: 1.02-1.36) rate and a more advanced tumor stage (RR =1.16, 95% CI: 1.03-1.32).
Our meta-analysis has confirmed the significant prognostic value of CTCs in head and neck cancer patients. The presence of CTCs could be used as a monitoring tool for tumor status of head and neck cancer, especially for the early detection of the tumor recurrence and progression, advanced disease and the node metastasis.
许多研究评估了循环肿瘤细胞（CTC）在头颈癌中的临床应用，但CTC的临床病理及预后意义仍不明确。
两位作者独立地在PubMed、MEDLINE、EMBASE、科学引文索引扩展版和Cochrane图书馆（从创刊至2017年2月）中使用关键词系统检索研究。估计风险比（HR）、风险率（RR）及其95%置信区间（95%CI）被设定为效应量。所有分析均使用STATA 12.0进行。
本荟萃分析共纳入17项研究。CTC阳性与总生存期差（HR = 2.80，95%CI：1.34 - 5.86）、无病生存期差（HR = 3.86，95%CI：2.03 - 7.36）和无进展生存期差（HR = 3.31，95%CI：1.71 - 6.42）显著相关。CTC阳性患者往往具有更高的复发率（RR = 2.13，95%CI：1.26 - 3.59）和区域淋巴结转移率（RR = 1.18，95%CI：1.02 - 1.36）以及更晚期的肿瘤分期（RR = 1.16，95%CI：1.03 - 1.32）。
我们的荟萃分析证实了CTC在头颈癌患者中的显著预后价值。CTC的存在可作为头颈癌肿瘤状态的监测工具，尤其是用于早期检测肿瘤复发和进展、晚期疾病及淋巴结转移。
