循环肿瘤细胞与鼻咽癌预后关系Meta分析  

Impact of circulating tumor cells on disease recurrence and survivals in patients with Nasopharyngeal carcinoma:A meta-analysis

作　　者：赵倩 杨振华[2] 刘瑛[2] 张余琴 张莹 马云龙 王奕鸣[1,2] ZHAO Qian;YANG Zhen-hua;LIU Ying;ZHANG Yu-qin;ZHANG Ying;MA Yun-long;WANG Yi-ming(The First Clinical Medical College of Jinan University,Guangzhou 510632,China;Department of Radiology Oncology,the First Affiliated Hospital of Jinan University,Guangzhou 510632,China)

机构地区：[1]暨南大学第一临床医学院,广东广州510632 [2]暨南大学第一附属医院肿瘤科,广东广州510632

出　　处：《社区医学杂志》2021年第9期582-587,共6页Journal Of Community Medicine

基　　金：广东省科技计划(2016ZC0051)。

摘　　要：目的探讨循环肿瘤细胞(CTCs)检测对鼻咽癌预后监测的临床价值。方法对PubMed、Cochrane Library、Embase、中国知网及万方数据库发表的文章进行全面搜索,检索时间均为建库至2020-02-29。主要研究人群为鼻咽癌患者,采集外周血进行CTCs检测,主要观察结局为总生存期(OS)和无进展生存期(PFS)。采用随机效应模型和固定效应模型计算主要结果的合并危险比(HR)和95%置信区间(95%CI)。使用Revman 5.3、Stata 12.0及适当的统计方法对纳入文献进行生存分析指标的Meta分析。结果共检索出317篇文献,按照纳入标准筛选,最终纳入5篇文献。共549份病例,其中CTCs(+)285例,CTCs(-)264例。采用纽卡斯尔-渥太华量表(NOS)进行质量评价,使用Revman5.3对符合条件549例患者的试验数据进行汇总。Meta分析结果显示,CTC阳性率与较短的OS(HR=2.58,95%CI为1.04~6.41,P=0.04)及PFS(HR=3.10,95%CI为2.07~4.62,P<0.001)相关。对异质性和发表偏倚进行评估,结果均不显著,没有明显的发表偏倚。结论 CTCs对鼻咽癌的预后及进展评估具有指导意义,CTCs检测阳性的鼻咽癌患者预后更差且发生远处转移机会更大。Objective To investigate the clinical value of circulating tumor cell(CTCs)detection in monitoring the prognosis of nasopharyngeal carcinoma(NPC).Methods A comprehensive search of articles published by PubMed,Cochrane Library,Embase,CNKI and Wanfang database,the retrieval time was all the time of the database construction until2020-02-29.The main study population was patients with nasopharyngeal carcinoma.Peripheral blood was collected for CTC detection.The main observation outcomes were overall survival(OS)and progression-free survival(PFS).Random effects model and fixed effects model were used to calculate the combined hazard ratio(HR)and 95%confidence interval(95%CI)of the main results.Revman 5.3,Stata 12.0 and appropriate statistical methods were used to conduct a metaanalysis of survival analysis indicators for the included literature.Results Totally 317 articles were retrieved.After screening according to the inclusion criteria,5 articles were finally included.There were 549 cases,of which 285 were CTCs positive and 264 were CTCs negative.The data of 549 eligible patients were evaluated by Newcastle-Ottawa Scale(NOS)and summarized with Revman 5.3 software,indicating that the CTC positive rate was significantly correlated with the shorter OS(HR=2.58,95%CI:1.04-6.41,P=0.04)and PFS(HR=3.10,95%CI:2.07-4.62,P<0.001).Stata 12.0 software was used to evaluate the heterogeneity and publication bias of OS and PFS results,and the results were not significant.Conclusions CTCs have guiding significance for the prognosis and progression assessment of nasopharyngeal carcinoma.Patients with nasopharyngeal carcinoma with positive CTCs have worse prognosis and greater chance of distant metastasis.

关 键 词：鼻咽癌 循环肿瘤细胞 预后 荟萃分析 

分 类 号：R739.62[医药卫生—肿瘤]