Meta-Analysis of the Prognostic Value of Circulating Tumor Cells in Breast Cancer
Meta-Analysis of the Prognostic Value of Circulating Tumor Cells in Breast Cancer
复制标题
乳腺癌循环肿瘤细胞预后价值的Meta分析
DOI：
10.1158/1078-0432.ccr-12-1587
复制
发表时间：
2012-10-15
影响因子：
11.5
通讯作者：
Pantel, Klaus
中科院分区：
文献类型：
--
作者：
Zhang, Liling;Riethdorf, Sabine;Pantel, Klaus
目的：检测乳腺癌患者循环肿瘤细胞（CTC）的预后价值目前仍有争议。在过去的几十年中，已经使用了不同的血液采集时间点和各种CTC测定。在这里，我们进行了第一次全面的荟萃分析发表的文献CTC的预后相关性，包括早期和晚期diseases.Experimental设计：1990年1月和2012年1月之间发表的文章进行了全面的搜索，进行了审查的每项研究和数据提取。分析的主要结局是早期乳腺癌患者的总生存期（OS）和无病生存期（DFS），以及转移性乳腺癌患者的无进展生存期（PFS）和OS。使用随机和固定效应模型计算合并风险比（HR）和95%置信区间（CI）。亚组和敏感性分析也进行了carried.Results：49个合格的研究招募6,825例患者被确定。CTC的存在与总人群中较短的生存期显著相关。CTC的预后价值在早期（DFS：HR，2.86; 95% CI，2.19-3.75; OS：HR，2.78; 95% CI，2.22-3.48）和转移性乳腺癌（PFS：HR，1.78; 95% CI，1.52-2.09; OS：HR，2.33; 95% CI，2.09-2.60）中均具有显著性。进一步的亚组分析表明，我们的结果是稳定的，无论CTC检测方法和时间点的bloodwithdraws.Conclusion：我们目前的荟萃分析表明，CTC的检测是一个稳定的crysticator在早期和转移性乳腺癌患者。需要进一步的研究来探索CTC在乳腺癌中的临床效用。临床癌症研究; 18（20）; 5701-10。(C)2012年AACR。
Purpose: The prognostic value of circulating tumor cells (CTC) detected in breast cancer patients is currently under debate. Different time points of blood collections and various CTC assays have been used in the past decades. Here, we conducted the first comprehensive meta-analysis of published literature on the prognostic relevance of CTC, including patients with early and advanced disease.Experimental Design: A comprehensive search for articles published between January 1990 and January 2012 was conducted; reviews of each study were conducted and data were extracted. The main outcomes analyzed were overall survival (OS) and disease-free survival (DFS) in early-stage breast cancer patients, as well as progression-free survival (PFS) and OS in metastatic breast cancer patients. Pooled hazard ratio (HR) and 95% confidence intervals (CIs) were calculated using the random and the fixed-effects models. Subgroup and sensitivity analyses were also conducted.Results: Forty-nine eligible studies enrolling 6,825 patients were identified. The presence of CTC was significantly associated with shorter survival in the total population. The prognostic value of CTC was significant in both early (DFS: HR, 2.86; 95% CI, 2.19-3.75; OS: HR, 2.78; 95% CI, 2.22-3.48) and metastatic breast cancer (PFS: HR, 1.78; 95% CI, 1.52-2.09; OS: HR, 2.33; 95% CI, 2.09-2.60). Further subgroup analyses showed that our results were stable irrespective of the CTC detection method and time point of blood withdrawal.Conclusion: Our present meta-analysis indicates that the detection of CTC is a stable prognosticator in patients with early-stage and metastatic breast cancer. Further studies are required to explore the clinical utility of CTC in breast cancer. Clin Cancer Res; 18(20); 5701-10. (C) 2012 AACR.