Prognostic and clinicopathological significance of circulating tumor cells detected by RT-PCR in non-metastatic colorectal cancer: a meta-analysis and systematic review
- PMID: 29115932
- PMCID: PMC5688806
- DOI: 10.1186/s12885-017-3704-8
Prognostic and clinicopathological significance of circulating tumor cells detected by RT-PCR in non-metastatic colorectal cancer: a meta-analysis and systematic review
Abstract
Background: Circulating tumor cells (CTCs) have been accepted as a prognostic marker in patients with metastatic colorectal cancer (mCRC, UICC stage IV). However, the prognostic value of CTCs in patients with non-metastatic colorectal cancer (non-mCRC, UICC stage I-III) still remains in dispute. A meta-analysis was performed to investigate the prognostic significance of CTCs detected by the RT-PCR method in patients diagnosed with non-mCRC patients.
Methods: A comprehensive literature search for relevant articles was performed in the EmBase, PubMed, Ovid, Web of Science, Cochrane library and Google Scholar databases. The studies were selected according to predetermined inclusion/exclusion criteria. Using the random-effects model of Stata software, version12.0 (2011) (Stata Corp, College Station, TX, USA), to conduct the meta-analysis, and the hazard ratio (HR), risk ratio (RR) and their 95% confidence intervals (95% CIs) were regarded as the effect measures. Subgroup analyses and meta-regression were also conducted to clarify the heterogeneity.
Results: Twelve eligible studies, containing 2363 patients with non-mCRC, were suitable for final analyses. The results showed that the overall survival (OS) (HR = 3.07, 95% CI: [2.05-4.624], P < 0.001; I2 = 55.7%, P = 0.008) and disease-free survival (DFS) (HR = 2.58, 95% CI: [2.00-3.32], P < 0.001; I2 = 34.0%, P = 0.085) were poorer in patients with CTC-positive, regardless of the sampling time, adjuvant therapy and TNM stage. CTC-positive was also significantly associated with regional lymph nodes (RLNs) metastasis (RR = 1.62, 95% CI: [1.17-2.23], P = 0.003; I2 = 74.6%, P<0.001), depth of infiltration (RR = 1.41, 95% CI: [1.03-1.92], P = 0.03; I2 = 38.3%, P = 0.136), vascular invasion (RR = 1.66, 95% CI: [1.17-2.36], P = 0.004; I2 = 46.0%, P = 0.135), tumor grade (RR = 1.19, 95% CI: [1.02-1.40], P = 0.029; I2 = 0%, P = 0.821) and tumor-node-metastasis (TNM) stage(I, II versus III) (RR = 0.76, 95% CI 0.71-0.81, P < 0.001; I2 = 0%, P = 0.717). However, there was no significant relationship between CTC-positive and tumor size (RR = 1.08, 95% CI: [0.94-1.24], P = 0.30; I2 = 0%, P = 0.528).
Conclusions: Detection of CTCs by RT-PCR method has prognostic value for non-mCRC patients, and CTC-positive was associated with poor prognosis and poor clinicopathological prognostic factors. However, the prognostic value of CTCs supports the use of CTCs as an indicator of metastatic disease prior to the current classification of mCRC meaning it is detectable by CT/MRI.
Keywords: Circulating tumor cells; Meta-analysis; Non-metastatic colorectal cancer; Prognosis; RT-PCR.
Conflict of interest statement
Ethics approval and consent to participate
Not applicable
Consent for publication
Not applicable
Competing interests
The authors declare that they have no competing interests.
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Figures
Similar articles
-
Circulating tumor cells predict survival benefit from chemotherapy in patients with lung cancer.Oncotarget. 2016 Oct 11;7(41):67586-67596. doi: 10.18632/oncotarget.11707. Oncotarget. 2016. PMID: 27588489 Free PMC article. Review.
-
Meta-analysis of the prognostic value of circulating tumor cells detected with the CellSearch System in colorectal cancer.BMC Cancer. 2015 Mar 30;15:202. doi: 10.1186/s12885-015-1218-9. BMC Cancer. 2015. PMID: 25880692 Free PMC article.
-
Relationship between circulating tumor cells and tumor response in colorectal cancer patients treated with chemotherapy: a meta-analysis.BMC Cancer. 2014 Dec 18;14:976. doi: 10.1186/1471-2407-14-976. BMC Cancer. 2014. PMID: 25519477 Free PMC article.
-
Circulating tumor cells (CTCs) detected by RT-PCR and its prognostic role in gastric cancer: a meta-analysis of published literature.PLoS One. 2014 Jun 5;9(6):e99259. doi: 10.1371/journal.pone.0099259. eCollection 2014. PLoS One. 2014. PMID: 24901848 Free PMC article.
-
Circulating tumor cells and prognosis of patients with resectable colorectal liver metastases or widespread metastatic colorectal cancer: a meta-analysis.Ann Surg Oncol. 2013 Jul;20(7):2156-65. doi: 10.1245/s10434-013-2907-8. Epub 2013 Mar 2. Ann Surg Oncol. 2013. PMID: 23456317 Review.
Cited by
-
Ibero-American Consensus Review and Incorporation of New Biomarkers for Clinical Practice in Colorectal Cancer.Cancers (Basel). 2023 Sep 1;15(17):4373. doi: 10.3390/cancers15174373. Cancers (Basel). 2023. PMID: 37686649 Free PMC article. Review.
-
Recent advances of small extracellular vesicle biomarkers in breast cancer diagnosis and prognosis.Mol Cancer. 2023 Feb 16;22(1):33. doi: 10.1186/s12943-023-01741-x. Mol Cancer. 2023. PMID: 36797736 Free PMC article. Review.
-
Impact of endoscopic metallic stent placement and emergency surgery on detection of viable circulating tumor cells for acute malignant left-sided colonic obstruction.World J Surg Oncol. 2023 Jan 2;21(1):1. doi: 10.1186/s12957-022-02879-6. World J Surg Oncol. 2023. PMID: 36588150 Free PMC article.
-
A meta-analysis of the value of circulating tumor cells in monitoring postoperative recurrence and metastasis of colorectal cancer.PLoS One. 2022 Sep 19;17(9):e0274282. doi: 10.1371/journal.pone.0274282. eCollection 2022. PLoS One. 2022. PMID: 36121855 Free PMC article.
-
Application of Microfluidics in Detection of Circulating Tumor Cells.Front Bioeng Biotechnol. 2022 May 12;10:907232. doi: 10.3389/fbioe.2022.907232. eCollection 2022. Front Bioeng Biotechnol. 2022. PMID: 35646880 Free PMC article. Review.
References
-
- Edwards BK, Ward E, Kohler BA, Eheman C, Zauber AG, Anderson RN, Jemal A, Schymura MJ, Lansdorp-Vogelaar I, Seeff LC, et al. Annual report to the nation on the status of cancer, 1975-2006, featuring colorectal cancer trends and impact of interventions (risk factors, screening, and treatment) to reduce future rates. Cancer. 2010;116(3):544–573. doi: 10.1002/cncr.24760. - DOI - PMC - PubMed
-
- Hayashi M, Inoue Y, Komeda K, Shimizu T, Asakuma M, Hirokawa F, Miyamoto Y, Okuda J, Takeshita A, Shibayama Y, et al. Clinicopathological analysis of recurrence patterns and prognostic factors for survival after hepatectomy for colorectal liver metastasis. BMC Surg. 2010;10:27. doi: 10.1186/1471-2482-10-27. - DOI - PMC - PubMed
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical