Li Zuxi, Song Meijuan, Han Shangjun, Jin Chuanwei, Yang Jing
The First Clinical School of Gansu University of Chinese Medicine, Lanzhou, China.
General Surgery Clinical Medical Center, Gansu Provincial Hospital, Lanzhou, China.
Front Oncol. 2022 Oct 13;12:963091. doi: 10.3389/fonc.2022.963091. eCollection 2022.
We conducted a meta-analysis to evaluate the relationship between circulating tumor cells (CTC) and the prognosis of patients with gastric cancer.
The cohort studies reporting on the relationship between CTC and prognosis of gastric cancer were collected from Pubmed, Cochrane, Embase, CNKI, WanFang Data, and VIP databases. The two researchers independently screened the literature, extracted the data, and evaluated the bias risk of the included literature. The data were analyzed by Revman software (Review Manager version 5.4).
A total of 14 retrospective cohort studies with 1053 patients were included. The results showed that the overall survival time (OS) and progression-free survival time (PFS) of CTC-positive patients were shorter compared to CTC-negative patients. Taking into consideration the critical value of CTC positive patients, country of origin, sample size, treatment mode, and study time, the subgroup analysis showed that CTC-positive was related to the shortening of OS in patients with gastric cancer. Based on the subgroup analysis of the factors such as CTC positive critical value < 2.8, sample size ≥ 75, mixed therapy, longer study duration, country, and immunofluorescence detection of CTC, it was found that OS in CTC positive group was shorter than that in CTC-negative group (all P<0.05), while the critical value of positive CTC ≥ 2.8, sample size ≥ 75, choice of treatment only for operation or non-operation, short study time and molecular detection of CTC were not associated with OS (all P>0.05). In addition, CTC-positive patients had a more advanced TNM staging, poorer tumor differentiation, and earlier distant metastasis.
CTC can be used as a prognostic indicator of gastric cancer. Gastric cancer patients with positive CTC may have a poorer prognosis compared to those with CTC-negative tumors.
https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022323155.
我们进行了一项荟萃分析，以评估循环肿瘤细胞（CTC）与胃癌患者预后之间的关系。
从PubMed、Cochrane、Embase、中国知网、万方数据和维普数据库中收集关于CTC与胃癌预后关系的队列研究。两位研究人员独立筛选文献、提取数据并评估纳入文献的偏倚风险。采用Revman软件（Review Manager版本5.4）进行数据分析。
共纳入14项回顾性队列研究，涉及1053例患者。结果显示，与CTC阴性患者相比，CTC阳性患者的总生存时间（OS）和无进展生存时间（PFS）较短。考虑到CTC阳性患者的临界值、原产国、样本量、治疗方式和研究时间，亚组分析表明，CTC阳性与胃癌患者OS缩短有关。基于对CTC阳性临界值<2.8、样本量≥75、联合治疗、研究持续时间较长、国家以及CTC免疫荧光检测等因素的亚组分析，发现CTC阳性组的OS短于CTC阴性组（所有P<0.05），而CTC阳性临界值≥2.8、样本量≥75、仅选择手术或非手术治疗、研究时间短以及CTC分子检测与OS无关（所有P>0.05）。此外，CTC阳性患者的TNM分期更晚、肿瘤分化更差且远处转移更早。
CTC可作为胃癌的预后指标。与CTC阴性肿瘤患者相比，CTC阳性的胃癌患者预后可能更差。
