State key Laboratory of Cancer Biology and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, 127 Changle West Road, Xi'an, Shaanxi Province, 710032, PR China.
School of Aerospace Medicine, Fourth Military Medical University, Xi'an, 710032, China.
BMC Cancer. 2020 Jun 22;20(1):581. doi: 10.1186/s12885-020-07059-x.
Esophageal carcinoma (EC) is the seventh-most prevalent tumor in the world, which is still one of the primary causes of tumor-related death. Identifying noteworthy biomarkers for EC is particularly significant in guiding effective treatment. Recently, circulating tumor cells (CTCs) in peripheral blood (PB) were intensively discussed as prognostic markers in patients with EC. However, an ongoing controversy still exists regarding the prognostic significance of CTCs determined by the CellSearch system in EC sufferers. This meta-analysis was designed to approach this topic.
We systematically conducted searches using PubMed, Medline, Web of Science and the Cochrane Library for relevant studies, which were published through February 20, 2020. Using the random-effects model, our study was performed in Review Manager software, with odds ratios (ORs), risk ratios (RRs), hazard ratios (HRs) and 95% confidence intervals (CIs) as the effect values.
Totally 7 articles were finally included in this study. For clinicopathological characteristics, the pooled results on TNM stage indicated that the III/IV group had higher rate of CTCs compared with the I/II group (OR = 1.36, 95% CI: 0.68-2.71, I = 0%). Incidence of CTCs was higher in patients with T3/T4 stage (OR = 2.92, 95% CI: 1.31-6.51, I = 0%) and distant metastasis group (OR = 5.18, 95% CI: 2.38-11.25, I = 0%) compared to patients with T1/T2 stage or non-metastatic group. The pooled analysis revealed that CTC positivity detected in EC patients was correlated with poor overall survival (OS) (HR = 2.83, 95% CI:1.99-4.03, I = 0%) and relapse-free survival (RFS) (HR = 4.71, 95% CI:2.73-8.13, I = 0%). When pooling the estimated RR, a poor therapeutic response to chemoradiotherapy was discovered in patients with CTC positivity (RR = 1.99, 95% CI:1.73-2.29, I = 60%).
In summary, our meta-analysis demonstrated that CTCs positivity determined by the CellSearch system are correlated with the prognosis of EC patients and might indicate a poor therapeutic response to chemotherapy in EC patients.
食管癌（EC）是世界上第七大常见肿瘤，仍是肿瘤相关死亡的主要原因之一。鉴定 EC 的有意义的生物标志物对于指导有效的治疗特别重要。最近，循环肿瘤细胞（CTC）在外周血（PB）中作为 EC 患者的预后标志物受到了广泛关注。然而，CellSearch 系统检测到的 CTC 对 EC 患者的预后意义仍存在争议。本荟萃分析旨在探讨这一问题。
我们通过 PubMed、Medline、Web of Science 和 Cochrane 图书馆系统地检索了截至 2020 年 2 月 20 日发表的相关研究。使用随机效应模型，我们在 Review Manager 软件中进行了研究，使用比值比（OR）、风险比（RR）、风险比（HR）和 95%置信区间（CI）作为效应值。
最终有 7 篇文章纳入本研究。对于临床病理特征，TNM 分期的汇总结果表明，III/IV 期组的 CTC 检出率高于 I/II 期组（OR=1.36，95%CI：0.68-2.71，I=0%）。T3/T4 期（OR=2.92，95%CI：1.31-6.51，I=0%）和远处转移组（OR=5.18，95%CI：2.38-11.25，I=0%）患者的 CTC 检出率高于 T1/T2 期或无转移组。荟萃分析显示，EC 患者的 CTC 阳性与总生存期（OS）（HR=2.83，95%CI：1.99-4.03，I=0%）和无复发生存期（RFS）（HR=4.71，95%CI：2.73-8.13，I=0%）较差相关。当汇总估计 RR 时，发现 CTC 阳性的患者对放化疗的治疗反应较差（RR=1.99，95%CI：1.73-2.29，I=60%）。
综上所述，本荟萃分析表明，CellSearch 系统检测到的 CTC 阳性与 EC 患者的预后相关，并可能表明 EC 患者对化疗的治疗反应较差。
