Pancreatic Research Group, Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Australia; Surgical Innovations Unit, Westmead Hospital, Westmead, Australia; Westmead Clinical School, University of Sydney, Westmead, Australia.
Centre for Circulating Tumour Cell Diagnostics and Research, Ingham Institute for Applied Medical Research, South Western Clinical School, University of New South Wales, School of Medicine, Western Sydney University, Australia; Surgical Innovations Unit, Westmead Hospital, Westmead, Australia; Westmead Clinical School, University of Sydney, Westmead, Australia.
Pancreatology. 2021 Jan;21(1):103-114. doi: 10.1016/j.pan.2020.11.022. Epub 2020 Dec 3.
The detection and quantification of circulating tumour cells (CTCs) in pancreatic cancer (PC) has the potential to provide prognostic information. The aim of this review was to provide an overview of the literature surrounding CTCs in PC.
A systematic literature review on CTCs in PC between 2005-2020 was performed. Data based on peripheral vein samples were used to determine the positivity rate of CTCs, their prognostic significance and their relative numbers compared to portal vein (PV) samples.
The overall CTC detection rate in forty-four articles was 65% (95%CI: 55-75%). Detection rate for CellSearch was 26% (95%CI: 14-38%), which was lower than for both filtration and microfluidic techniques. In nine studies with >50 patients, overall survival was worse with CTC positivity (HR 1.82; 95%CI: 1.61-2.05). Five of seven studies which described PV CTC collection provided patient-level data. PV CTC yield was 7.7-fold (95%CI 1.35-43.9) that of peripheral blood.
CTCs were detected in the peripheral circulation of most patients with PC and may be related to prognosis and disease stage. PV blood contains more CTCs than peripheral blood sampling. This review points to the maturation of techniques of CTC enrichment, and its evidence base for eventual clinical deployment.
循环肿瘤细胞（CTCs）在胰腺癌（PC）中的检测和定量分析有可能提供预后信息。本综述的目的是概述 CTC 在 PC 中的研究文献。
对 2005 年至 2020 年间 CTC 在 PC 中的应用进行了系统的文献综述。使用基于外周静脉样本的数据来确定 CTC 的阳性率、其预后意义以及与门静脉（PV）样本相比的相对数量。
在 44 篇文章中，CTCs 的总体检测率为 65%（95%CI：55-75%）。CellSearch 的检测率为 26%（95%CI：14-38%），低于过滤和微流控技术。在 9 项纳入超过 50 名患者的研究中，CTC 阳性的总生存率更差（HR 1.82；95%CI：1.61-2.05）。描述了 PVCTC 采集的 7 项研究中的 5 项提供了患者水平的数据。PVCTC 的产量是外周血的 7.7 倍（95%CI 1.35-43.9）。
大多数 PC 患者的外周循环中都检测到了 CTCs，并且可能与预后和疾病分期有关。PV 血样比外周血样含有更多的 CTCs。本综述指出了 CTC 富集技术的成熟，并为其最终的临床应用提供了证据基础。
