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Meta-Analysis
. 2013 Nov 4;8(11):e78070.
doi: 10.1371/journal.pone.0078070. eCollection 2013.

Prognostic significance of circulating tumor cells in non-small-cell lung cancer patients: a meta-analysis

Jianwei Wang, Ke Wang, Jianjun Xu, Jian Huang, Tao Zhang
Meta-Analysis

Prognostic significance of circulating tumor cells in non-small-cell lung cancer patients: a meta-analysis

Jianwei Wang et al. PLoS One. .

Erratum in

  • PLoS One. 2014;9(1). doi:10.1371/annotation/6633ed7f-a10c-4f6d-9d1d-9c1245822eb7. Huang, Jianwei [corrected to Wang, Jianwei]

Abstract

Background: The prognostic significance of circulating tumor cells (CTCs) detected in patients with non-small-cell lung cancer (NSCLC) is still inconsistent. We aimed to assess the prognostic relevance of CTCs using a meta-analysis.

Methods: We searched PubMed, Web of Science and EMBASE for relevant studies that assessed the prognostic relevance of CTCs in NSCLC. Statistical analyses were conducted to calculate the summary incidence, odds ratio, relative risks (RRs) and 95% confidence intervals (CIs) using fixed or random-effects models according to the heterogeneity of included studies.

Results: A total of 20 studies, comprising 1576 patients, met the inclusion criteria. In identified studies, CTCs were not correlated with histology (adenocarcinoma vs squamous cell carcinoma) (odds ratio [OR] = 0.88; 95% confidence interval [CI]: 0.59-1.33; Z = -0.61; P = 0.545). However, pooled analyses showed that CTCs were associated with lymph node metastasis (OR = 2.06; 95% CI: 1.18-3.62; Z = 2.20; P = 0.027) and tumor stage (OR = 1.95; 95% CI: 1.08-3.54; Z = 2.53; P = 0.011). Moreover, CTCs were significantly associated with shorter overall survival (relative risk [RR] = 2.19; 95% CI: 1.53-3.12; Z = 4.32; P<0.0001) and progression-free/disease-free survival (RR = 2.14; 95% CI: 1.36-3.38; Z = 3.28; P<0.0001).

Conclusion: The presence of CTCs indicates a poor prognosis in patients with NSCLC. Further well-designed prospective studies are required to explore the clinical applications of CTCs in lung cancer.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Flow chart of selecting the eligible publications.
Figure 2
Figure 2. Forrest plot of odds ratios (ORs) was evaluated for association between the presence of CTCs and histology.
Figure 3
Figure 3. Forrest plot of odds ratios (ORs) was evaluated for association between the presence of CTCs and lymph node metastasis.
Figure 4
Figure 4. Forrest plot of odds ratios (ORs) was evaluated for association between the presence of CTCs and tumor stage.
Figure 5
Figure 5. Meta-analysis of relative risk (RR) for the association of the presence of CTCs with overall survival (OS).
It showed that patients with CTCs have a poorer survival compared to those without CTCs.
Figure 6
Figure 6. Meta-analysis of RR for the association of the presence of CTCs with progression-free survival (PFS) /disease-free survival (DFS).
See this image and copyright information in PMC

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