Prognostic value of circulating tumor cells in esophageal cancer

AIM To perform a meta-analysis of the related studies to assess whether circulating tumor cells(CTCs) can be used as a prognostic marker of esophageal cancer.METHODS Pub Med, Embase, Cochrane Library and references in relevant studies were searched to assess the prognostic relevance of CTCs in patie...

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Published inWorld journal of gastroenterology : WJG Vol. 23; no. 7; pp. 1310 - 1318
Main Authors Xu, Hai-Tao, Miao, Jing, Liu, Jian-Wei, Zhang, Lian-Guo, Zhang, Qing-Guang
Format Journal Article
LanguageEnglish
Published United States Baishideng Publishing Group Inc 21.02.2017
Subjects
Disease Progression
Esophageal Neoplasms - blood
Esophageal Neoplasms - diagnosis
Esophageal Neoplasms - pathology
Humans
Meta-Analysis
Neoplasm Metastasis
Neoplastic Cells, Circulating
Prognosis
Proportional Hazards Models
Treatment Outcome
Prognosis
Circulating tumor cells
Esophageal cancer
Meta-analysis
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Summary:AIM To perform a meta-analysis of the related studies to assess whether circulating tumor cells(CTCs) can be used as a prognostic marker of esophageal cancer.METHODS Pub Med, Embase, Cochrane Library and references in relevant studies were searched to assess the prognostic relevance of CTCs in patients with esophageal cancer. The primary outcome assessed was overall survival(OS). The meta-analysis was performed using the random effects model, with hazard ratio(HR), risk ratio(RR) and 95% confidence intervals(95%CIs) as effect measures.RESULTS Nine eligible studies were included involving a total of 911 esophageal cancer patients. Overall analyses revealed that CTCs-positivity predicted disease progression(HR = 2.77, 95%CI: 1.75-4.40, P < 0.0001) and reduced OS(HR = 2.67, 95%CI: 1.99-3.58, P < 0.00001). Further subgroup analyses demonstrated that CTCs-positive patients also had poor OS in different subsets. Moreover, CTCs-positivity was also significantly associated with TNM stage(RR = 1.48, 95%CI: 1.07-2.06, P = 0.02) and T stage(RR = 1.44, 95%CI: 1.13-1.84, P = 0.003) in esophageal cancer.CONCLUSION Detection of CTCs at baseline indicates poor prognosis in patients with esophageal cancer. However, this finding relies on data from observational studies and is potentially subject to selection bias. Prospective trials are warranted.
Bibliography:Hai-Tao Xu;Jing Miao;Jian-Wei Liu;Lian-Guo Zhang;Qing-Guang Zhang;Department of Thoracic Surgery, Affiliated Hospital of Binzhou Medical University;Department of Neonatal Intensive Care Unit, Binzhou People’s Hospital
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Correspondence to: Qing-Guang Zhang, MD, Department of Thoracic Surgery, Affiliated Hospital of Binzhou Medical University, No. 661, Huanghe Erlu, Binzhou 256603, Shandong Province, China. drzhangqingg@126.com
Author contributions: Xu HT and Miao J contributed equally to this work as co-first authors; Xu HT designed the research, analyzed the data and wrote the manuscript; Miao J designed the research, analyzed the data and wrote the manuscript; Liu JW performed the research and contributed analytical tools; Zhang LG performed the research; Zhang QG conceived and designed the research, and revised the manuscript as corresponding author.
Telephone: +86-543-3258731 Fax: +86-543-3257792
ISSN:1007-9327
2219-2840
DOI:10.3748/wjg.v23.i7.1310