Cui Kai, Ou Yang, Shen Yangyang, Li Sheng, Sun Ziqiang
Shandong Cancer Hospital affiliated to Shandong University.
Shandong Academy of Medical Sciences.
Medicine (Baltimore). 2020 Oct 2;99(40):e22242. doi: 10.1097/MD.0000000000022242.
To evaluate the clinical value of circulating tumor cell (CTC) detection in peripheral blood for the diagnosis and prognosis of hepatocellular carcinoma (HCC).
Public databases were searched, and a meta-analysis was performed to determine the specificity, sensitivity, negative- likelihood ratio (NLR) and positive-likelihood ratio (PLR), and diagnostic odds ratio (dOR) of CTC detection for the diagnosis of HCC. Hazard ratios (HRs) and 95% confidence intervals (CIs) were analyzed for the association of CTC detection with overall survival (OS) and HCC recurrence. The Meta-DiSc 1.4 and Review Manager 5.2 software programs were used for statistical analysis.
Meta-analysis of 20 studies including 1191 patients showed that the specificity, sensitivity, NLR, PLR, and dOR of CTC testing for HCC diagnosis were 0.60 (95% CI = 0.57-0.63), 0.95 (95%CI = 0.93-0.96), 0.36 (95%CI = 0.28-0.48), 11.64 (95%CI = 5.85-23.14), and 38.94 (95%CI = 18.33-82.75), respectively. Meta-analysis of 18 studies including 1466 patients indicated that the OS of CTC-positive HCC patients was less than that of CTC-negative patients (HR = 2.31; 95% CI = 1.55-3.42; P < .01). Meta-analysis of 5 studies including 339 patients revealed that the presence of CTCs in peripheral blood significantly increased the risk of HCC recurrence (HR = 3.03, 95% CI = 1.89-4.86; P < .01).
CTCs in peripheral blood may be a useful marker for HCC diagnosis. In addition, the prognosis of CTC-positive HCC patients was significantly worse than that of CTC-negative HCC patients. Therefore, further studies are warranted to confirm the clinical potential of CTC detection in peripheral blood in patients with primary HCC.
评估外周血循环肿瘤细胞（CTC）检测对肝细胞癌（HCC）诊断及预后的临床价值。
检索公共数据库，并进行荟萃分析以确定CTC检测对HCC诊断的特异性、敏感性、阴性似然比（NLR）、阳性似然比（PLR）及诊断比值比（dOR）。分析CTC检测与总生存期（OS）及HCC复发的关联的风险比（HRs）及95%置信区间（CIs）。使用Meta-DiSc 1.4和Review Manager 5.2软件程序进行统计分析。
对包括1191例患者的20项研究的荟萃分析显示，CTC检测对HCC诊断的特异性、敏感性、NLR、PLR及dOR分别为0.60（95%CI = 0.57 - 0.63）、0.95（95%CI = 0.93 - 0.96）、0.36（95%CI = 0.28 - 0.48）、11.64（95%CI = 5.85 - 23.14）及38.94（95%CI = 18.33 - 82.75）。对包括1466例患者的18项研究的荟萃分析表明，CTC阳性HCC患者的OS低于CTC阴性患者（HR = 2.31；95%CI = 1.55 - 3.42；P <.01）。对包括339例患者的5项研究的荟萃分析显示，外周血中存在CTC显著增加HCC复发风险（HR = 3.03，95%CI = 1.89 - 4.86；P <.01）。
外周血中的CTC可能是HCC诊断的有用标志物。此外，CTC阳性HCC患者的预后明显差于CTC阴性HCC患者。因此，有必要进一步研究以证实外周血CTC检测在原发性HCC患者中的临床潜力。
