Clinicopathological and prognostic significance of circulating tumor cells in patients with lung cancer: a meta-analysis

Tingjuan Xu, Guodong Shen, Min Cheng, Weiping Xu, Gan Shen and Shilian Hu _

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Oncotarget. 2017; 8:62524-62536. https://doi.org/10.18632/oncotarget.19122

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Tingjuan Xu1,2, Guodong Shen1,2, Min Cheng1,2, Weiping Xu1,2, Gan Shen1,2 and Shilian Hu1,2

1Gerontology Institute of Anhui Province, Anhui Provincial Hospital Affiliated Anhui Medical University, Hefei 230001, China

2Anhui Provincial Key Laboratory of Tumor Immunotherapy and Nutrition Therapy, Hefei 230001, China

Correspondence to:

Shilian Hu, email: [email protected]

Keywords: circulating tumor cells, lung cancer, prognosis, clinicopathological parameters, meta-analysis

Received: November 04, 2016    Accepted: April 25, 2017    Published: July 10, 2017


Background: The 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.

Methods: The 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.

Results: Thirty 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]).

Conclusion: The detection of circulating tumor cells in the peripheral blood of patients with lung cancer can be indicative of a poor prognosis.

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