摘要
目的大量研究表明,外周血中循环肿瘤细胞(CTCs)水平可能与胰腺癌患者生存期有关,但仍有部分研究存在争议性结论。本研究旨在探讨外周血CTCs预测胰腺癌患者临床预后的价值。方法计算机检索PubMed、Embase、CBM、万方、Web of Science、Cochrane Library、CISCOM、CINAHL、谷歌学术、中国知网等中英文数据库,检索范围从建库至2013-08-01。采用STATA 12.0软件进行分析,计算HR及其95%CI评价CTCs预测胰腺癌患者临床预后的价值。结果本研究共计纳入9项队列研究,共623例胰腺癌患者,包括268例CTCs阳性患者和355例CTCs阴性患者。Meta分析结果表明:CTCs阳性表达患者与无进展生存期(PFS)有关〔HR=0.52,95%CI(0.27,0.77),P<0.001〕;此外,CTCs阳性组患者总生存期(OS)短于CTCs阴性组患者〔HR=0.73,95%CI(0.54,0.93),P<0.001〕。根据种族差异进行亚组分析发现,亚洲人群和欧美人群CTCs阳性组患者的OS均低于CTCs阴性组患者(P<0.05)。结论 CTCs阳性表达患者PFS和OS均短于CTCs阴性表达患者,故检测外周血CTCs表达情况对预测胰腺癌的转移或复发及临床预后均具有重要意义。
Objective Increasing scientific evidences suggest that circulating tumor ceils （CTCs） in peripheral blood may be a powerful predictor of the prognostic survival time in patients with-pancreatic cancer. However, many existing studies have yielded inconclusive results. This meta - analysis aims to assess the prognostic value of CTCs in patients with pancreatic cancer. Methods An extensive literary search for relevant studies was conducted on PubMed, Embase, Wanfang Data, Web of Science, Cochrane Library, CISCOM, CINAHL, Google Scholar, CNKI and CBM databases from their inception through August 1st, 2013. The meta-analysis was then performed using STATA 12. 0..The crude hazard ratio （HR） was calculated with a 95% confidence interval （CI）. Results Nine cohort studies were included in this meta - analysis with a total of 623 pancreatic cancer patients. This number included 268 CTCs - positive patients and 355 CTCs - negative patients. Our meta - analysis revealed that patients in the CTCs - positive group were significantly associated with progression - free survival （PFS） （ HR = 0. 52, 95% CI （0.27, 0.77 ）, P 〈 0. 001 ]. Furthermore, pancreatic cancer patients in the CTCs - positive group also showed worse overall survival （OS） than those in the CTCs - negative group [HR =0.73, 95% CI （0.54, 0.93）, P 〈 0. 001 ]. Subgroup analysis by ethnicity indicated that CTCs - positive patients had worse OS than CTCs - negative ones among both Asian and Cancasian populations （P 〈 0. 05 ）. Conclusion In conclusion, our meta - analysis suggests that both PFS and OS of CTCs - positive patients with pancreatic cancer are worse than those of CTCs - negative ones. Detection of CTCs in peripheral blood may be a promising prognostic biomarker for the detection of both the recurrence and metastasis of pancreatic cancer.
出处
《中国全科医学》
CAS
CSCD
北大核心
2014年第20期2357-2361,共5页
Chinese General Practice
关键词
循环肿瘤细胞
胰腺癌
预后
META分析
Circulating tumor cells
Pancreatic cancer
Prognosis
Meta - analysis
