Abstract
BackgroundThe prognostic significance of circulating tumor cells in patients with lung cancer is controversial. Therefore, we aimed to comprehensively and quantitatively assess the prognostic role of CTCs in patients with lung cancer.MethodsThe relevant literature was searched using PubMed, the Cochrane database and the China National Knowledge Internet database (up to June 2016). Using Review Manager 5.1.2, a meta-analysis was performed using hazard ratio (HR), odds ratio (OR) and 95% confidence interval (CI) as effect values.ResultsThirty studies comprising 2,060 patients with lung cancer were analyzed. The pooled HR values showed that circulating tumor cells were significantly correlated with overall survival (HR =2.63, 95% CI [2.04, 3.39]) and progression-free survival (HR =3.74, 95% CI [2.49, 5.61]) in these patients. Further subgroup analyses were conducted and categorized by sampling time, detection method, and histological type; these analyses showed the same trend. The pooled OR values showed that circulating tumor cells were associated with non small cell lung cancer stage(OR = 2.11, 95% CI [1.42, 3.14]), small cell lung cancer stage (OR = 10.91, 95% CI [4.10, 29.06]), distant metastasis (OR =7.06, 95%CI [2.82, 17.66]), lymph node metastasis (OR =2.31, 95% CI [1.19,4.46]), and performance status(OR =0.42, 95%CI [0.22, 0.78]).ConclusionThe detection of circulating tumor cells in the peripheral blood of patients with lung cancer can be indicative of a poor prognosis.
Highlights
Lung cancer is one of the deadliest diseases in the world
The pooled hazard ratio (HR) values showed that circulating tumor cells were significantly correlated with overall survival (HR =2.63, 95% confidence interval (CI) [2.04, 3.39]) and progression-free survival (HR =3.74, 95% CI [2.49, 5.61]) in these patients
The pooled odds ratio (OR) values showed that circulating tumor cells were associated with non small cell lung cancer stage(OR = 2.11, 95% CI [1.42, 3.14]), small cell lung cancer stage (OR = 10.91, 95% CI [4.10, 29.06]), distant metastasis (OR =7.06, 95%CI [2.82, 17.66]), lymph node metastasis (OR =2.31, 95% CI [1.19,4.46]), and performance status(OR =0.42, 95%CI [0.22, 0.78])
Summary
Lung cancer is one of the deadliest diseases in the world. Less than 15% of lung cancer patients survive for more than 5 years after being diagnosed [1]. Due to its aggressive behavior and greater invasive ability than other types of cancer, the predominant cause of treatment failure in patients with lung cancer is believed to be distant metastases, even during early-stage disease. 25% to 50% of patients with earlystage non small cell lung cancer (NSCLC) show tumor recurrence, even after tumor resection [2, 3]. The prognostic significance of circulating tumor cells in patients with lung cancer is controversial. We aimed to comprehensively and quantitatively assess the prognostic role of CTCs in patients with lung cancer
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