循环肿瘤细胞与转移性前列腺癌患者预后关系的Meta分析

Prognostic Value of Circulating Tumor Cells for Metastatic Prostate Cancer:A Metaanalysis

目的 通过Meta分析系统评价循环肿瘤细胞（circulating tumor cells, CTCs）与转移性前列腺癌患者的预后关系。方法 检索PubMed、EMbase、Cochrane图书馆、中国期刊全文数据库（CNKI）及中国生物医学文献数据库（CBM）等，收集患者血液中CTCs数量与前列腺癌Gleason评分0~10级的前列腺癌患者预后相关的研究。以总生存期（OS）为观察终点，采用Review Manager 5.3进行Meta分析。结果 共有10篇英文文献纳入Meta分析，结果显示CTCs阳性组较CTCs阴性组在总生存期（OS）上预后差（HR=2.47, 95%CI： 2.02～3.02, P〈0.00001），根据检测时间与检测方法进行亚组分析，CTCs阳性组比CTCs阴性组患者预后差。同时分析结果还提示CTCs阳性与前列腺癌Gleason评分呈正相关（OR=2.23, 95%CI： 1.41～3.53，P〈0.04）。与前列腺癌特异性抗原（PSA）水平、是否有骨外多发转移均无相关性。结论 外周血CTCs阳性是转移性前列腺癌患者预后的风险因素，且与检测时间、检查方法无关。

Objective To systematically review the prognostic value of circulating tumor cells（CTCs） for metastatic prostate cancer patients by Meta-analysis. Methods We electronically searched PubMed, EMbase, Cochrane Library, CNKI and CBM for collecting the studies about the prognostic relevance of CTCs in the peripheral blood of Gleason score 0-10th metastatic prostate cancer patients. The observation endpoint was the overall survival（OS）. Review Manager 5.3 was used for this analysis. Results A total of 10 studies involving 1 137 patients of metastatic prostate cancer were eligible for the final analyses. The results of Metaanalysis showed that the presence of CTCs was associated with OS（HR=2.47, 95%CI： 2.02-3.02, P〈0.00001）. According to the subgroup analysis by the detection time and the detection method, CTCs positive group show the poor prognosis than CTCs negative group patients. CTCs positive group showed a significantly positive correlation with the Gleason score of prostate cancer （OR=2.23, 95%CI： 1.41-3.53, P〈0.04）, rather than PSA or extra bone metastasis. Conclusion CTCs is an adverse prognostic factor for metastatic prostate cancer patients, which is not significantly influenced by the detection time and check method.