循环肿瘤细胞和播散肿瘤细胞对食管癌患者预后的meta分析

目的 用循环肿瘤细胞(CTCs)和播散肿瘤细胞(DTCs)预测食管癌患者的预后仍存在争议,本文旨在探究食管癌患者CTCs/DTCs是否与患者临床病理特征、预后及生存状况存在相关性.方法 通过PubMed、Web of Science、Embase及Cochrane数据库检索所有CTCs/DTCs相关研究.制定文献纳入/排除标准并依此选择文献.以比值比(OR)、相对危险度(RR)、风险比(HR)和95％可信区间(95％ CI)作为效应指标,用Review Manager5.3、Statal2.0软件进行计算和分析.结果 共纳入19项研究,包含1766例食管癌患者.Meta分析显示,CTCs/DTCs与患者下列临床病理参数:肿瘤分期(OR=1.95)、浸润深度(OR=1.99)、淋巴结转移(OR=2.44SEN)、远处转移(OR=5.98sEN)、分化程度(OR=1.67)、淋巴脉管转移(OR=4.48);预后:复发(RR=6.86SEN)、转移(RR=3.22);生存状况:总体生存率(OS)整体分析(HR=3.46)、无病生存率/无进展生存率(DFS/PFS)整体分析(HR=3.00)显著相关.结论 食管癌患者CTCs/DTCs与肿瘤分期、浸润深度、淋巴结转移、远处转移、分化程度、淋巴脉管转移、复发、转移显著相关,也与总体生存率、无病生存率/无进展生存率显著相关.因此,CTCs/DTCs可作为食管癌患者临床预测指标.

Prognostic value of circulating tumor cells and disseminated tumor cells in patients with esophageal cancer: a meta-analysis

Objective To explore the correlations of circulating tumor cells (CTCs) and disseminated tumor cells (DTCs) with the clinicopathological characteristics,prognostic events,and survival outcomes in esophageal cancer (EC) patients.Methods The PubMed,Web of Science,Embase database and Cochrane database were searched for studies reporting the outcomes of interest.The studies were selected according to established inclusion/exclusion criteria.Meta-analysis of the studies was performed using Review Manager 5.3 and Stata12.0 software with the odds ratio (OR),risk ratio (RR),hazard ratio (HR),and 95％ confidence interval (95％ CI) as the effect indexes.Results Nineteen studies involving a total of 1766 patients were included in the analysis.Significant correlations of CTCs and DTCs were found with the clinicopathological parameters including the tumor stage (OR=1.95),depth of invasion (OR=1.99),lymph node metastasis (OR=2.44SEN),distal metastasis (OR=5.98SEN),histological differentiation (OR=1.67) and lymphovascular invasion (OR=4.48).CTCs and DTCs were also correlated with the prognostic events including relapse (RR=6.86SEN) and metastasis (RR=3.22) and with the survival outcomes including the overall survival (OS) overall analysis (HR=3.46) and disease-free survival/progression-free survival (DFS/PFS) overall analysis (HR=3.00).Conclusion CTCs and DTCs are significantly associated with an advanced tumor stage,depth of tumor invasion,lymph node metastasis,distant metastasis before therapy,differentiation,lymphovascular invasion,relapse and metastasis in patients with EC.They are also significantly correlated with a poorer survival for OS and DFS/PFS to serve as clinical and prognostic predictors in patients with EC.