Prognostic Value of Circulating Tumor Cells for Metastatic Prostate Cancer: A Meta-analysis
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摘要:目的
通过Meta分析系统评价循环肿瘤细胞（circulating tumor cells, CTCs）与转移性前列腺癌患者的预后关系。
方法检索PubMed、EMbase、Cochrane图书馆、中国期刊全文数据库（CNKI）及中国生物医学文献数据库（CBM）等，收集患者血液中CTCs数量与前列腺癌Gleason评分0~10级的前列腺癌患者预后相关的研究。以总生存期（OS）为观察终点，采用Review Manager 5.3进行Meta分析。
结果共有10篇英文文献纳入Meta分析，结果显示CTCs阳性组较CTCs阴性组在总生存期（OS）上预后差（HR=2.47, 95%CI: 2.02~3.02, P＜0.00001），根据检测时间与检测方法进行亚组分析，CTCs阳性组比CTCs阴性组患者预后差。同时分析结果还提示CTCs阳性与前列腺癌Gleason评分呈正相关（OR=2.23, 95%CI: 1.41~3.53，P＜0.04）。与前列腺癌特异性抗原（PSA）水平、是否有骨外多发转移均无相关性。
结论外周血CTCs阳性是转移性前列腺癌患者预后的风险因素，且与检测时间、检查方法无关。
Abstract:ObjectiveTo systematically review the prognostic value of circulating tumor cells(CTCs) for metastatic prostate cancer patients by Meta-analysis.
MethodsWe electronically searched PubMed, EMbase, Cochrane Library, CNKI and CBM for collecting the studies about the prognostic relevance of CTCs in the peripheral blood of Gleason score 0-10th metastatic prostate cancer patients. The observation endpoint was the overall survival(OS). Review Manager 5.3 was used for this analysis.
ResultsA total of 10 studies involving 1 137 patients of metastatic prostate cancer were eligible for the final analyses. The results of Meta-analysis showed that the presence of CTCs was associated with OS(HR=2.47, 95%CI: 2.02-3.02, P＜0.00001). According to the subgroup analysis by the detection time and the detection method, CTCs positive group show the poor prognosis than CTCs negative group patients. CTCs positive group showed a significantly positive correlation with the Gleason score of prostate cancer (OR=2.23, 95%CI: 1.41-3.53, P＜0.04), rather than PSA or extra bone metastasis.
ConclusionCTCs is an adverse prognostic factor for metastatic prostate cancer patients, which is not significantly influenced by the detection time and check method.
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Key words:
- Circulating tumor cells /
- Metastatic prostate cancer /
- Prognosis /
- Meta-analysis
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图 1 CTCs与转移性前列腺癌患者预后的Meta分析
Figure 1 Meta-analysis of relationship between CTCs and prognosis of metastatic prostate cancer patients
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图 2 治疗前基线采血（0~5周）和治疗后采血（≥5~20周）患者预后的Meta分析
Figure 2 Meta-analysis of the prognosis of patients with baseline blood collection before treatment(0-5w) and after treatment with blood sampling (≥5-20w)
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图 3 CTCs与Gleason评分关系的Meta分析森林图
Figure 3 Meta-analysis of relationship between CTCs and Gleason score of prostate cancer
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图 4 CTCs与PSA关系的Meta分析森林图
Figure 4 Meta-analysis of relationship between CTCs and PSA of prostate cancer
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图 5 CTCs与是否有骨外转移关系的Meta分析森林图
Figure 5 Meta-analysis of relationship between CTCs and bone metastasis
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