摘要
目的系统评价循环肿瘤细胞（CTCs）对非转移性乳腺癌预后的预测价值。方法计算机检索PubMed、EMbase、WanFangData、CNKI和CBM数据库，收集CTCs与TNMI。Ⅲ期非转移性乳腺癌预后的队列研究，检索时限均从建库至2014年3月20日。由2位研究者按纳入与排除标准独立筛选文献、提取资料和评价纳入研究的方法学质量后，采用RevMan5．2软件进行Meta分析。结果最终纳入7个队列研究，共计1780例患者。Meta分析结果显示：CTCs阳性组的无病生存率[RR=2．24，95％CI（1．92，2．61），P〈0．00001]和总生存率[RR=2．55，95％CI（1．99，3．28），P〈0．00001]均低于CTCs阴性组。按CTCs检测时间行亚组分析，结果显示辅助化疗前后，CTCs对非转移性乳腺癌的无病生存率与总生存率亦均有预测价值（P〈0．0004）。结论外周血CTCs是非转移性乳腺癌的不良预后因素，且不受辅助化疗的影响。
Objective To systematically review the prognostic value of circulating tumour cells （CTCs） in non-metastatic breast cancer patients. Methods We electronically searched PubMed, EMbase, WanFang Data, CNKI and CBM for collecting cohort studies about the prognostic relevance of CTCs in the peripheral blood of stage I to III breast cancer patients from inception to March 20th, 2014. Two reviewers independently screened studies according to the inclusion and exclusion criteria, extracted data and assessed methodological quality. Meta-analysis was conducted using RevMan 5.2 software. Results A total of 7 studies involving 1 780 patients were eligible for final analyses. The results of meta-analysis showed that, the presence of CTCs was associated with both poor DFS （RR=2.24, 95%CI 1.92 to 2.61, P〈0.000 01） and OS （RR=2.55, 95%CI 1.99 to 3.28, P〈0.000 01）. The results of subgroup analysis by detection time of CTCs showed that CTCs detected before and after adjuvant chemotherapy was a statistically significant prognostic factor （P,〈 0.000 4）. Conclusion CTCs is an adverse prognostic factor in non-metastatic breast cancer patients, which is not significantly influenced by adjuvant chemotherapy.
出处
《中国循证医学杂志》
CSCD
2014年第6期721-728,共8页
Chinese Journal of Evidence-based Medicine
基金
新疆维吾尔自治区自然科学基金(编号:2011211A084)
