Shan Wang, Xiaolin Liu, Hongwei Lv, Jing Yu, Huihui Li
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Inclusion criteria were cohort studies involving NSCLC patients, focusing on peripheral blood CTCs, and assessing outcomes such as pre- and posttreatment CTC rates or levels, progression-free survival (PFS), and overall survival (OS). Two reviewers independently extracted the data and assessed risk of bias using the Newcastle-Ottawa Scale. We utilized Review Manager 5.4.1 for meta-analysis, calculating pooled odds ratios (ORs) for dichotomous outcomes, mean differences for continuous variables and hazard ratios (HRs) for survival data, applying fixed- or random-effects models based on heterogeneity assessed by the <i>I</i><sup>2</sup> statistic. This study was registered in PROSPERO (No. CRD42023450035).</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Twenty-two eligible studies with a total of 1674 NSCLC patients were included. Meta-analysis results showed that the CTCs-positive rate (OR = 0.59, 95% CI 0.45 to 0.77, <i>p = </i>0.0001) and CTCs count (mean difference = –3.10, 95% CI –5.52 to –0.69, <i>p = </i>0.01) were significantly decreased after antitumor treatment. Compared with the CTCs nonreduced group, the CTC-reduced group showed better PFS (HR = 1.71, 95% CI 1.35 to 2.17, <i>p </i>< 0.00001) and OS (HR = 1.50, 95% CI 1.21 to 1.86, <i>p = </i>0.0003) after treatment. PFS and OS in CTC-positive groups were lower than those in the CTCs-negative group pretreatment (HR = 2.49, 95% CI 1.78 to 3.47, <i>p</i> < 0.00001; HR = 1.80, 95% CI 1.29 to 2.52, <i>p</i> = 0.0006) and posttreatment (HR = 3.36, 95% CI 2.12 to 5.33, <i>p </i>< 0.00001; HR = 3.31, 95% CI 1.75 to 6.27, <i>p = </i>0.0002).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>CTCs can be used as a biomarker to monitor NSCLC efficacy, predict prognosis and guide follow-up treatment.</p>\n </section>\n </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":null,"pages":null},"PeriodicalIF":3.6000,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The detection of circulating tumor cells indicates poor therapeutic efficacy and prognosis in patients with nonsmall cell lung cancer: A systematic review and meta-analysis\",\"authors\":\"Shan Wang, Xiaolin Liu, Hongwei Lv, Jing Yu, Huihui Li\",\"doi\":\"10.1111/jebm.12606\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Objective</h3>\\n \\n <p>The efficacy and prognostic value of circulating tumor cells (CTCs) in nonsmall cell lung cancer (NSCLC) are controversial based on the existing research. 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引用次数: 0
摘要
目的根据现有研究，循环肿瘤细胞（CTCs）在非小细胞肺癌（NSCLC）中的疗效和预后价值存在争议。本系统综述和荟萃分析评估了 CTCs 在 NSCLC 治疗监测和预后预测中的意义，支持其作为临床生物标记物的潜力。纳入标准是涉及 NSCLC 患者的队列研究，侧重于外周血 CTC，并评估治疗前后的 CTC 率或水平、无进展生存期（PFS）和总生存期（OS）等结果。两名审稿人独立提取数据，并使用纽卡斯尔-渥太华量表评估偏倚风险。我们使用Review Manager 5.4.1进行荟萃分析，计算二分结果的汇总比值比（ORs）、连续变量的平均差和生存数据的危险比（HRs），根据I2统计量评估的异质性应用固定或随机效应模型。本研究已在 PROSPERO 注册（编号：CRD42023450035）。结果纳入了 22 项符合条件的研究，共有 1674 名 NSCLC 患者。Meta 分析结果显示，抗肿瘤治疗后，CTCs 阳性率（OR = 0.59，95% CI 0.45 至 0.77，P = 0.0001）和 CTCs 计数（平均差 = -3.10，95% CI -5.52 至 -0.69，P = 0.01）显著下降。与未减少 CTCs 组相比，减少 CTCs 组在治疗后显示出更好的 PFS（HR = 1.71，95% CI 1.35 至 2.17，p < 0.00001）和 OS（HR = 1.50，95% CI 1.21 至 1.86，p = 0.0003）。CTC阳性组治疗前的PFS和OS低于CTC阴性组（HR = 2.49，95% CI 1.78 to 3.47，p <0.00001；HR = 1.80，95% CI 1.29 to 2.52，p = 0.0006）和治疗后（HR = 3.36，95% CI 2.12 to 5.33，p <0.00001；HR = 3.31，95% CI 1.75 to 6.27，p = 0.0002）。结论CTCs可作为监测NSCLC疗效、预测预后和指导后续治疗的生物标志物。
The detection of circulating tumor cells indicates poor therapeutic efficacy and prognosis in patients with nonsmall cell lung cancer: A systematic review and meta-analysis
Objective
The efficacy and prognostic value of circulating tumor cells (CTCs) in nonsmall cell lung cancer (NSCLC) are controversial based on the existing research. This systematic review and meta-analysis evaluated the significance of CTCs in NSCLC therapy monitoring and prognosis prediction, supporting their potential as clinical biomarkers.
Methods
We conducted a comprehensive search of PubMed, Embase, Web of Science, The Cochrane Library, WanFang Data, CNKI, and VIP through September 20, 2023. Inclusion criteria were cohort studies involving NSCLC patients, focusing on peripheral blood CTCs, and assessing outcomes such as pre- and posttreatment CTC rates or levels, progression-free survival (PFS), and overall survival (OS). Two reviewers independently extracted the data and assessed risk of bias using the Newcastle-Ottawa Scale. We utilized Review Manager 5.4.1 for meta-analysis, calculating pooled odds ratios (ORs) for dichotomous outcomes, mean differences for continuous variables and hazard ratios (HRs) for survival data, applying fixed- or random-effects models based on heterogeneity assessed by the I2 statistic. This study was registered in PROSPERO (No. CRD42023450035).
Results
Twenty-two eligible studies with a total of 1674 NSCLC patients were included. Meta-analysis results showed that the CTCs-positive rate (OR = 0.59, 95% CI 0.45 to 0.77, p = 0.0001) and CTCs count (mean difference = –3.10, 95% CI –5.52 to –0.69, p = 0.01) were significantly decreased after antitumor treatment. Compared with the CTCs nonreduced group, the CTC-reduced group showed better PFS (HR = 1.71, 95% CI 1.35 to 2.17, p < 0.00001) and OS (HR = 1.50, 95% CI 1.21 to 1.86, p = 0.0003) after treatment. PFS and OS in CTC-positive groups were lower than those in the CTCs-negative group pretreatment (HR = 2.49, 95% CI 1.78 to 3.47, p < 0.00001; HR = 1.80, 95% CI 1.29 to 2.52, p = 0.0006) and posttreatment (HR = 3.36, 95% CI 2.12 to 5.33, p < 0.00001; HR = 3.31, 95% CI 1.75 to 6.27, p = 0.0002).
Conclusions
CTCs can be used as a biomarker to monitor NSCLC efficacy, predict prognosis and guide follow-up treatment.
期刊介绍：
The Journal of Evidence-Based Medicine (EMB) is an esteemed international healthcare and medical decision-making journal, dedicated to publishing groundbreaking research outcomes in evidence-based decision-making, research, practice, and education. Serving as the official English-language journal of the Cochrane China Centre and West China Hospital of Sichuan University, we eagerly welcome editorials, commentaries, and systematic reviews encompassing various topics such as clinical trials, policy, drug and patient safety, education, and knowledge translation.
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