Background

It has been shown that circulating tumor cells in peripheral blood can be used to predict survival in patients with breast, prostate and other epithelial tumors. In the present study, we performed a meta-analysis to evaluate the prognostic role of circulating tumor cells (CTCs) in patients with pancreatic cancer.

Methods

A systematic literature search of the databases was conducted from the inception to Jul 20, 2019. Relative risks (RRs) with 95% confidence intervals (CIs) were calculated under a fixed or random effect model.

Results

A total of 19 studies with 1320 confirmed individuals were included. Our meta-analysis showed that patients in the CTC-positive group had a significantly shorter overall survival (OS) (RR = 0.47, 95%CI = 0.33–0.61, P < 0.001) and progression-free survival (PFS) (P = 0.003) than CTC-negative patients. Moreover, subgroup analysis by ethnicity indicated that CTC-positive patients had a significantly shorter OS in both Asian and Western populations. Further subgroup analysis by detection methods, treatments, and Tumor Node Metastasis (TNM) stages also indicated that CTC-positive patients were associated with significant decreases in both OS and PFS in most subgroups.

Conclusion

Our meta-analysis indicates that CTC-positive patients have a worse OS and PFS than CTC-negative patients, which suggests that CTCs may act as predictive biomarkers for pancreatic cancer patients before treatment.

中文翻译：

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胰腺癌患者外周血循环肿瘤细胞及其预后作用：系统评价和荟萃分析。

背景

已经表明，外周血中的循环肿瘤细胞可用于预测乳腺、前列腺和其他上皮肿瘤患者的存活率。在本研究中，我们进行了一项荟萃分析来评估循环肿瘤细胞 (CTC) 在胰腺癌患者中的预后作用。

方法

从数据库开始到 2019 年 7 月 20 日进行了系统的文献检索。 在固定或随机效应模型下计算了具有 95% 置信区间 (CI) 的相对风险 (RR)。

结果

共纳入 19 项研究，共 1320 名确诊个体。我们的荟萃分析显示，CTC 阳性组患者的总生存期（OS）（RR = 0.47，95%CI = 0.33–0.61，P < 0.001）和无进展生存期（PFS）（P = 0.003) 比 CTC 阴性患者。此外，按种族进行的亚组分析表明，在亚洲和西方人群中，CTC 阳性患者的 OS 显着缩短。通过检测方法、治疗和肿瘤淋巴结转移 (TNM) 分期进行的进一步亚组分析也表明，在大多数亚组中，CTC 阳性患者与 OS 和 PFS 显着降低相关。

结论

我们的荟萃分析表明，CTC 阳性患者的 OS 和 PFS 比 CTC 阴性患者更差，这表明 CTC 可以作为胰腺癌患者治疗前的预测生物标志物。