Circulating Tumor Cells as a Predictive Biomarker in Resectable Lung Cancer: A Systematic Review and Meta-Analysis

被引:27
作者
Wankhede, Durgesh [1 ]
Grover, Sandeep [2 ]
Hofman, Paul [3 ,4 ,5 ,6 ]
机构
[1] All India Inst Med Sci, Dept Surg Oncol, New Delhi 110029, India
[2] Univ klinikum Giessen & Marburg Standort Marburg, Ctr Human Genet, D-35055 Marburg, Germany
[3] Univ Cote Azur, Lab Clin & Expt Pathol, CHU Nice, FHU OncoAge, F-06100 Nice, France
[4] Univ Cote Azur, Team 4, IRCAN, UMR 7284,U10181,FHU OncoAge, F-06107 Nice, France
[5] Univ Cote Azur, Hosp Integrated Biobank BB 0033 00025, CHU Nice, FHU OncoAge, F-06100 Nice, France
[6] European Liquid Biopsy Soc, Martinistr 52 Bldg N27 Room 4-003, D-20246 Hamburg, Germany
关键词
lung cancer; non-small cell lung cancer; NSCLC; surgery; circulating tumor cells; prognosis; PULMONARY VENOUS-BLOOD; POLYMERASE CHAIN-REACTION; INDIVIDUAL PATIENT DATA; RNA-POSITIVE CELLS; MESSENGER-RNA; PROGNOSTIC-SIGNIFICANCE; SURGICAL MANIPULATION; DISEASE RECURRENCE; SURVIVAL; VEIN;
D O I
10.3390/cancers14246112
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Simple Summary Lung cancer is the most common cause of cancer-related deaths worldwide. Circulating tumor cells (CTC) are cancer cells that are disseminated in the bloodstream and may be responsible for early recurrence and poor rates of survival. We conducted a systematic review and meta-analysis of 18 prospective studies comprising 1321 patients that reported CTC in resectable non-small cell lung cancer. Our analysis revealed that the presence of CTC in both the baseline and postoperative period was associated with an increased risk of recurrence and death compared to an absence of CTC in lung cancer patients. The results were independent of sources of CTC (peripheral, pulmonary vein), detection methods, and follow-up duration. CTCs hold a significant prognostic and predictive potential, as evident in our meta-analysis; however, heterogeneity of data, publication bias, and variable cut-off values limit its clinical utility. Background: In breast, prostate, and other epithelial tumors, circulating tumor cells (CTC) in peripheral blood may predict survival. Our study evaluated the prognostic significance of baseline and postoperative CTC in patients with early non-small cell lung cancer (NSCLC) through a meta-analytic approach. Methods: Prospective studies comparing survival outcomes between positive (CTC+) and negative CTC (CTC-) patients were systematically searched. Primary outcomes were overall (OS) and disease-free survival (DFS) with hazard ratio (HR) and 95% confidence interval (CI) as the effect measure. Pooled HR determined the prognostic role under a fixed-effect or random-effect model depending on heterogeneity. Results: Eighteen studies with 1321 patients were eligible. CTC+ patients were associated with an increased risk of death (HR 3.53, 95% CI 2.51-4.95; p < 0.00001) and relapse (HR 2.97, 95% CI 2.08-4.22; p < 0.00001). Subgroup analysis results were consistent in different subsets, including time points (baseline and postoperative) and sources (peripheral and pulmonary vein) of blood collection, detection methods (label-free, label-dependent, and RT-PCR), and follow-up duration. Conclusion: Our meta-analysis revealed that CTC is a promising predictive biomarker for stratifying survival outcomes in patients with early-stage NSCLC. However, future studies are required to validate these findings and standardize detection methods.
引用
收藏
页数:14
相关论文
共 50 条
[21]   Circulating tumour cells in pancreatic cancer: A systematic review and meta-analysis of clinicopathological implications [J].
Pang, Tony C. Y. ;
Po, Joseph W. ;
Becker, Therese M. ;
Goldstein, David ;
Pirola, Romano C. ;
Wilson, Jeremy S. ;
Apte, Minoti V. .
PANCREATOLOGY, 2021, 21 (01) :103-114
[22]   Prognostic value of circulating tumor cells detected with the CellSearch system in esophageal cancer patients: a systematic review and meta-analysis [J].
Li, Yiding ;
Wu, Guiling ;
Yang, Wanli ;
Wang, Xiaoqian ;
Duan, Lili ;
Niu, Liaoran ;
Zhang, Yujie ;
Liu, Jinqiang ;
Hong, Liu ;
Fan, Daiming .
BMC CANCER, 2020, 20 (01)
[23]   Predictive and prognostic value of circulating tumor cell detection in lung cancer: A clinician's perspective [J].
Tognela, Annette ;
Spring, Kevin J. ;
Becker, Therese ;
Caixeiro, Nicole J. ;
Bray, Victoria J. ;
Yip, Po Yee ;
Chua, Wei ;
Lim, Stephanie H. ;
De Souza, Paul .
CRITICAL REVIEWS IN ONCOLOGY HEMATOLOGY, 2015, 93 (02) :90-102
[24]   Circulating and disseminated tumor cells in pancreatic cancer and their role in patient prognosis: a systematic review and meta-analysis [J].
Stephenson, David ;
Nahm, Christopher ;
Chua, Terence ;
Gill, Anthony ;
Mittal, Anubhav ;
de Reuver, Philip ;
Samra, Jaswinder .
ONCOTARGET, 2017, 8 (63) :107223-107236
[25]   Diagnostic and prognostic value of circulating tumor cells in renal cell cancer: A systematic review and meta-analysis [J].
Cao, Liang ;
Yang, Wenming ;
Zhao, Xiang ;
Chen, Zhibin .
ASIAN JOURNAL OF SURGERY, 2024, 47 (08) :3425-3434
[26]   Effect of phenotypic detection of circulating tumor cells marked by epithelial-mesenchymal transformation on the prognosis of lung cancer A protocol for systematic review and meta-analysis [J].
Ge, Bin ;
Wang, Yong ;
Lei, Shaoqing ;
Zhang, Jincao .
MEDICINE, 2020, 99 (44) :E22960
[27]   Neoadjuvant immunotherapy for advanced, resectable non-small cell lung cancer: A systematic review and meta-analysis [J].
Wu, Yajing ;
Verma, Vivek ;
Gay, Carl M. ;
Chen, Yujia ;
Liang, Fei ;
Lin, Qiang ;
Wang, Jianing ;
Zhang, Wei ;
Hui, Zhouguang ;
Zhao, Min ;
Wang, Jun ;
Chang, Joe Y. .
CANCER, 2023, 129 (13) :1969-1985
[28]   Association between circulating tumor cells in the peripheral blood and the prognosis of gastric cancer patients: a meta-analysis [J].
Jin, Tao ;
Liang, Pan-Ping ;
Chen, Ze-Hua ;
He, Feng-Jun ;
Li, Ze-Dong ;
Chen, Zheng-Wen ;
Hu, Jian-Kun ;
Yang, Kun .
THERAPEUTIC ADVANCES IN MEDICAL ONCOLOGY, 2023, 15
[29]   Soluble PD-L1 as a predictive biomarker in lung cancer: a systematic review and meta-analysis [J].
Cheng, Yang ;
Wang, Chong ;
Wang, Yan ;
Dai, Li .
FUTURE ONCOLOGY, 2021, 18 (02) :261-273
[30]   The value of folate receptor-positive circulating tumour cells as a diagnostic biomarker for lung cancer: a systematic review and meta-analysis [J].
Chen, Fangjun ;
Ni, Yihong ;
Zhang, Jin ;
Hao, Yang ;
Tian, Zhoujunyi ;
Qiang, Guangliang .
JOURNAL OF INTERNATIONAL MEDICAL RESEARCH, 2023, 51 (09)