LongHua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China.
Int J Colorectal Dis. 2020 Aug;35(8):1463-1475. doi: 10.1007/s00384-020-03667-y. Epub 2020 Jun 22.
Surgical resection is the primary treatment for patients with nonmetastatic colorectal cancer (CRC). However, even after undergoing radical resection procedure, 30-50% of patients will still experience relapse. Circulation tumor DNA (ctDNA), deriving from tumor cells, is shed into the bloodstream and is a potential predictive biomarker of recurrence in CRC. This meta-analysis was performed to identify the clinical value of ctDNA in predicting the recurrence of CRC patients in post-operative.
PubMed, Embase, The Cochrane Library, and Web of Science were comprehensively searched to identify the studies that reported the function of ctDNA for predicting recurrence in CRC patients. The eligible studies were pooled to calculate the relative risk (RR) of recurrence in ctDNA positive and negative groups. The data of ctDNA on recurrence-free survival (RFS) were extracted and computed in hazard ratio (HR) and 95% confident interval (CI). Subgroup analyses were also performed.
A total of 7 studies including 424 patients were included and analyzed in our meta-analysis. The results showed that pooled RR was 4.65 (95%CI: 2.68-8.08, P < 0.05), indicating ctDNA positive could predict the recurrence of CRC after curative surgical. The pooled HR demonstrated strong connection between ctDNA positive and RFS in patients with CRC (HR = 9.14, 95%CI: 4.02-20.75, P < 0.05).
Evidence from the meta-analysis suggested that ctDNA is a promising potential biomarker for predicting postoperative recurrence of CRC. Given the inherent limitations of this study, we look forward to more well-designed clinical studies to validate and update this analysis in the future.
手术切除是非转移性结直肠癌(CRC)患者的主要治疗方法。然而,即使在接受根治性切除手术后,仍有 30-50%的患者会复发。循环肿瘤 DNA(ctDNA)源自肿瘤细胞,会脱落到血液中,是 CRC 复发的潜在预测生物标志物。本荟萃分析旨在确定 ctDNA 在预测术后 CRC 患者复发中的临床价值。
全面检索 PubMed、Embase、The Cochrane Library 和 Web of Science,以确定报告 ctDNA 预测 CRC 患者复发功能的研究。将符合条件的研究进行汇总,以计算 ctDNA 阳性和阴性组的复发相对风险(RR)。提取并计算 ctDNA 关于无复发生存(RFS)的数据的风险比(HR)和 95%置信区间(CI)。还进行了亚组分析。
共有 7 项研究纳入了 424 名患者进行荟萃分析。结果表明,汇总 RR 为 4.65(95%CI:2.68-8.08,P<0.05),表明 ctDNA 阳性可预测根治性手术后 CRC 的复发。荟萃分析还表明 ctDNA 阳性与 CRC 患者 RFS 之间存在强烈关联(HR=9.14,95%CI:4.02-20.75,P<0.05)。
荟萃分析的证据表明,ctDNA 是预测 CRC 术后复发的一种很有前途的潜在生物标志物。鉴于本研究的固有局限性,我们期待未来有更多设计良好的临床研究来验证和更新该分析。