Department of Medicine, Medical College of Qingdao University, 266003, Qingdao, China.
Department of Hematology, The Affiliated Hospital of Qingdao University, 266003, Qingdao, China.
Clin Exp Med. 2022 Feb;22(1):1-7. doi: 10.1007/s10238-021-00718-8. Epub 2021 May 15.
Circulating tumor DNA (ctDNA) can be used to evaluate the prognosis of lymphoma. However, there is no uniform consensus about the mechanistic role that ctDNA plays in the prognosis of lymphoma. This meta-analysis explores the prognostic value of ctDNA in lymphoma, especially in diffuse large B cell lymphoma (DLBCL). All relevant reports published as of May 14, 2020, were retrieved by searching electronic databases in Pubmed, Embase and Cochrane Library. The prognostic value of ctDNA was evaluated using meta-analysis. Revman 5.3 software was used for prognostic data extraction and analysis. Eight studies, including a total of 767 lymphoma patients, were enrolled in this meta-analysis. Five out of eight studies investigated the association between ctDNA levels and progression-free survival (PFS) in 501 lymphoma patients, indicating that high levels of ctDNA were significantly associated with poor PFS (HR 2.24, 95%CI: 1.63-3.08, P < 0.00001). We conducted a subgroup analysis of 379 patients with DLBCL across three of the studies and came to the same conclusion (HR 2.01, 95%CI: 1.42-2.85, P < 0.0001). Two studies with a total of 192 lymphoma patients described the association between ctDNA levels and event-free survival (EFS), showing that high levels of ctDNA were also associated with adverse EFS (HR 4.53, 95%CI: 1.79-11.47, P = 0.001). The remaining two studies analyzed the potential clinical value of ctDNA for predicting the overall survival time (OS) of DLBCL patients, demonstrating that high levels of ctDNA correlated with inferior OS (HR 3.09, 95%CI: 1.50-6.35, P = 0.002). Our meta-analysis showed that high levels of ctDNA were associated with poor prognosis in patients with lymphoma, especially DLBCL.
循环肿瘤 DNA（ctDNA）可用于评估淋巴瘤的预后。然而，ctDNA 在淋巴瘤预后中的作用机制尚未达成统一共识。本荟萃分析探讨了 ctDNA 在淋巴瘤，尤其是弥漫性大 B 细胞淋巴瘤（DLBCL）中的预后价值。通过在 Pubmed、Embase 和 Cochrane Library 电子数据库中检索，检索截至 2020 年 5 月 14 日发表的所有相关报告。使用荟萃分析评估 ctDNA 的预后价值。Revman 5.3 软件用于预后数据提取和分析。共有 8 项研究，共纳入 767 例淋巴瘤患者，纳入本荟萃分析。其中 5 项研究调查了 501 例淋巴瘤患者 ctDNA 水平与无进展生存期（PFS）之间的关系，结果表明 ctDNA 水平较高与较差的 PFS 显著相关（HR 2.24，95%CI：1.63-3.08，P<0.00001）。我们对其中 3 项研究的 379 例 DLBCL 患者进行了亚组分析，得出了相同的结论（HR 2.01，95%CI：1.42-2.85，P<0.0001）。另外 2 项研究共纳入 192 例淋巴瘤患者，描述了 ctDNA 水平与无事件生存期（EFS）之间的关系，结果表明 ctDNA 水平较高也与不良 EFS 相关（HR 4.53，95%CI：1.79-11.47，P=0.001）。其余 2 项研究分析了 ctDNA 预测 DLBCL 患者总生存时间（OS）的潜在临床价值，结果表明 ctDNA 水平较高与较差的 OS 相关（HR 3.09，95%CI：1.50-6.35，P=0.002）。本荟萃分析表明，ctDNA 水平较高与淋巴瘤患者的不良预后相关，尤其是 DLBCL。
