循环癌细胞和胃癌预后关系的Meta分析  

Meta-analysis on Association of Circulating Tumor Cells with Prognosis in Gastric Cancer

作　　者：郑刚 王舒艺[2] 熊斌[2] 

机构地区：[1]武汉市第五医院普通外科,武汉430050 [2]武汉大学中南医院肿瘤科肿瘤生物学行为湖北省重点实验室

出　　处：《肿瘤防治研究》2012年第9期1139-1145,共7页Cancer Research on Prevention and Treatment

摘　　要：目的探讨循环癌细胞(CTCs)和胃癌患者肿瘤分期、淋巴结转移和预后的相关性。方法计算机检索Embase、Medline和PubMed数据库,根据纳入和排除标准筛选文献,对入选文献的特征、研究结果的内容进行摘录和评价,并对各研究结果进行异质性检验和数据合并。结果入选文献18篇,均发表于2000—2011年。Ⅰ～Ⅱ期胃癌术前CTCs阳性率显著低于Ⅲ期患者(RR=0.63,95%CI:0.48～0.84),有淋巴结转移患者的CTCs阳性率高于无淋巴结转移的患者(RR=1.42,95%CI:1.20～1.68)。术前CTCs阳性的患者术后发生复发或转移的风险显著高于阴性患者(RR=2.42,95%CI:1.94～3.02),而且总体生存率更低(HR=1.83,95%CI:1.30～2.60)。结论术前CTCs检测阳性是胃癌患者预后不良的一个重要判断指标,可为胃癌的治疗决策提供参考。Objective To study the relationship between lymph node metastasis,TNM stages,recurrence and overall survival with circulating tumor positive.Methods Embase,Medline and PubMed databases were searched by computer,based on inclusion and exclusion criteria for the screening literature.The research findings were extracted and evaluated by characteristics of selected literature.And all the results were tested for heterogeneity and data consolidation.Results Eighteen studies published between 2000 and 2011matched to the selection criteria and were suitable for inclusion in this meta-analysis.There was a significantly higher incidence of circulating tumor cells（56.1%）in lymph node positive compared with negative groups（37.8%）[RR=1.42,confidence interval（95%CI）=1.20～1.68],and a significantly increased circulating tumor cells positive rate（36.7%）in TNM stage 1,2compared with in stage 3patients（56.6%）[RR=0.63,95%CI：0.48～0.84].Post-operative recurrence rate was significantly higher in the circulating tumor cell positive versus negative groups[RR=2.42,95%CI：1.94～3.02].Overall survival was significantly shorter in circulating tumor cells positive versus negative groups（HR=1.83,95%CI=1.30～2.60）.Conclusion This study highlights the potential importance of circulating tumor cells detection in the peripheral blood of gastric cancers as a prognostic indicator and might benefit to the strategy of treatment.

关 键 词：胃肿瘤 肿瘤循环细胞 预后 RT-PCR META分析 

分 类 号：R735.2[医药卫生—肿瘤]