Jin Tao, Liang Pan-Ping, Chen Ze-Hua, He Feng-Jun, Li Ze-Dong, Chen Zheng-Wen, Hu Jian-Kun, Yang Kun
Department of General Surgery & Laboratory of Gastric Cancer, State Key Laboratory of Biotherapy/Collaborative Innovation Center of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China Gastric Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Department of General Surgery & Laboratory of Gastric Cancer, State Key Laboratory of Biotherapy/Collaborative Innovation Center of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
Ther Adv Med Oncol. 2023 Jul 8;15:17588359231183678. doi: 10.1177/17588359231183678. eCollection 2023.
Research on the correlation between circulating tumor cells (CTCs) and gastric cancer (GC) has increased rapidly in recent years. However, whether CTCs are associated with GC patient prognosis is highly controversial.
This study aims to evaluate the value of CTCs to predict the prognosis of GC patients.
A meta-analysis.
We searched the PubMed, Embase, and Cochrane Library databases for studies that reported the prognostic value of CTCs in GC patients before October 2022. The association between CTCs and overall survival (OS) and disease-free survival (DFS)/recurrence-free survival (RFS) and progression-free survival (PFS) of GC patients was assessed. Subgroup analyses were stratified by sampling times (pre-treatment and post-treatment), detection targets, detection method, treatment method, tumor stage, region, and HR (Hazard Ratio) extraction methods. Sensitivity analysis was performed by removing individual studies to assess the stability of the results. Publication bias was evaluated using funnel plots, Egger's test, and Begg's test.
We initially screened 2000 studies, of which 28 were available for further analysis, involving 2383 GC patients. The pooled analysis concluded that the detection of CTCs was associated with poor OS (HR = 1.933, 95% CI 1.657-2.256, < 0.001), DFS/RFS (HR = 3.228, 95% CI 2.475-4.211, < 0.001), and PFS (HR = 3.272, 95% CI 1.970-5.435, < 0.001). Furthermore, the subgroup analysis stratified by tumor stage ( < 0.01), HR extraction methods ( < 0.001), detection targets ( < 0.001), detection method ( < 0.001), sampling times ( < 0.001), and treatment method ( < 0.001) all showed that CTC detection was associated with poor OS and DFS/RFS for GC patients. Furthermore, the study showed that CTCs were associated with the poor DFS/RFS of GC when CTCs were detected for patients from Asian or No-Asian regions ( < 0.05). In addition, higher CTCs predicted poorer OS for GC patients who are from Asian regions ( < 0.001), but without statistical difference for GC patients from No-Asian regions ( = 0.490).
CTC detection in peripheral blood was associated with poor OS, DFS/RFS, and PFS in patients with GC.
近年来，循环肿瘤细胞（CTC）与胃癌（GC）之间相关性的研究迅速增加。然而，CTC是否与GC患者的预后相关存在高度争议。
本研究旨在评估CTC对预测GC患者预后的价值。
一项荟萃分析。
我们检索了PubMed、Embase和Cochrane图书馆数据库，以查找2022年10月之前报道CTC对GC患者预后价值的研究。评估了CTC与GC患者总生存期（OS）、无病生存期（DFS）/无复发生存期（RFS）和无进展生存期（PFS）之间的关联。亚组分析按采样时间（治疗前和治疗后）、检测靶点、检测方法、治疗方法、肿瘤分期、地区和风险比（HR）提取方法进行分层。通过剔除个别研究进行敏感性分析，以评估结果的稳定性。使用漏斗图、Egger检验和Begg检验评估发表偏倚。
我们初步筛选了2000项研究，其中28项可供进一步分析，涉及2383例GC患者。汇总分析得出，检测CTC与较差的OS（HR = 1.933，95%CI 1.657 - 2.256，P < 0.001）、DFS/RFS（HR = 3.228，95%CI 2.475 - 4.211，P < 0.001）和PFS（HR = 3.272，95%CI 1.970 - 5.435，P < 0.001）相关。此外，按肿瘤分期（P < 0.01）、HR提取方法（P < 0.001）、检测靶点（P < 0.001）、检测方法（P < 0.001）、采样时间（P < 0.001）和治疗方法（P < 0.001）分层的亚组分析均显示，检测CTC与GC患者较差的OS和DFS/RFS相关。此外，研究表明，当检测亚洲或非亚洲地区患者的CTC时，CTC与GC较差的DFS/RFS相关（P < 0.05）。此外，较高的CTC水平预测亚洲地区GC患者的OS较差（P < 0.001），但非亚洲地区GC患者无统计学差异（P = 0.490）。
外周血中检测CTC与GC患者较差的OS、DFS/RFS和PFS相关。
