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Meta-Analysis
. 2015 Mar 30:15:202.
doi: 10.1186/s12885-015-1218-9.

Meta-analysis of the prognostic value of circulating tumor cells detected with the CellSearch System in colorectal cancer

Xuanzhang Huang  1 , Peng Gao  2 , Yongxi Song  3 , Jingxu Sun  4 , Xiaowan Chen  5 , Junhua Zhao  6 , Huimian Xu  7 , Zhenning Wang  8
Affiliations
Meta-Analysis

Meta-analysis of the prognostic value of circulating tumor cells detected with the CellSearch System in colorectal cancer

Xuanzhang Huang et al. BMC Cancer. .

Abstract

Background: The prognostic value of circulating tumor cells (CTCs) detected with the CellSearch System in patients with colorectal cancer (CRC) is controversial. The aim of our meta-analysis was to evaluate whether the detection of CTCs in the peripheral blood with the standardized CellSearch System has prognostic utility for patients with CRC.

Methods: The PubMed, Science Citation Index, Cochrane Database, Embase, and the references in relevant studies were systematically searched (up to December, 2014). No search restrictions were imposed. Our meta-analysis was performed in Stata software, version 12.0 (2011) (Stata Corp, College Station, TX, USA), with the odds ratio (OR), risk ratio (RR), hazard ratio (HR), and 95% confidence interval (95% CI) as the effect measures. Subgroup and sensitivity analyses were also conducted.

Results: Eleven studies containing 1847 patients with CRC were analyzed. There was a significantly higher incidence of CTCs in the metastasis-positive group than in the metastasis-negative group (OR = 4.06, 95% CI [1.74, 9.50], P < 0.01, I(2) = 0%). For hepatic metastasis, a type of metastasis, a higher incidence of CTCs was observed in the hepatic-metastasis-positive group than in the -negative group (OR = 2.61, 95% CI [1.73, 3.96], P < 0.01, I(2) = 0%). The presence of CTCs was significantly related to overall survival (HR = 2.00, 95% CI [1.49, 2.69], P < 0.01, I(2) = 67.1%) and progression-free survival (HR = 1.80, 95% CI [1.52, 2.13], P < 0.01, I(2) = 43.9%) of patients with CRC, regardless of the sampling time. The response rate for the CTC(+) groups was significantly lower than that for the CTC(-) groups at baseline and during treatment (baseline: 33% versus 39%, RR = 0.79, 95% CI [0.63, 0.99], P = 0.04, I(2) = 7.0%; during treatment: 17% versus 46%, RR = 0.41, 95% CI [0.22, 0.77], P = 0.01, I(2) = 0.0%;).

Conclusions: Our meta-analysis indicates that the detection of CTCs in the peripheral blood with the CellSearch System has prognostic utility for patients with CRC.

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Figures

Figure 1
Figure 1
Selection of studies. Flow chart showing the selection process for the including studies.
Figure 2
Figure 2
Odds ratios summary for all kinds of tumor metastasis (A) and hepatic metastasis (B). A: The estimated odds ratio (OR) was summarized for the relationship between all kinds of tumor metastasis and CTC detection. B: The OR was summarized for the relationship between hepatic metastasis and CTC detection.
Figure 3
Figure 3
Hazard ratios summary for overall survival (A) and progression-free survival (B). A: The estimated hazard ratio (HR) was summarized for overall survival with CTC detection. B: The estimated HR was summarized for progression-free survival with CTC detection.
Figure 4
Figure 4
Risk ratios summary for the correlation of tumor response and CTCs. A: The estimated risk ratio (RR) was summarized for the correlation of tumor response with CTCs detected at baseline time. B: The estimated RR was summarized for the correlation of tumor response with CTCs detected at during-treatment time.
Figure 5
Figure 5
Funnel plot analysis. A: overall survival; B: progression-free survival. A: Funnel plot of the studies on overall survival. B: Funnel plot of the studies on progression-free survival.
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