骨髓微转移肿瘤细胞预测乳腺癌患者预后的Meta分析
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A Meta-analysis of disseminating tumor cells in bone marrow predicting prognosis of patients with breast cancer
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    目的:系统性评价骨髓中微转移肿瘤细胞(disseminating tumor cell,DTC)在乳腺癌患者预后预测中的作用-方法:检索Medline-Embase-中国数字化期刊全文数据库(CNKI)-万方数据库及维普全文网,收集DTC预测乳腺癌患者预后的研究,以无进展生存期(progression-free survival,PFS)和总生存期(overall survival,OS)为观察终点,采用Review Manager 5.1.4进行Meta分析-结果:14篇英文文献包含4 091例乳腺癌患者纳入荟萃分析-结果提示DTC阳性组较阴性组在PFS[HR=1.83(95%CI:1.51~2.22),n = 12,I2 = 75%]和OS[HR=1.59(95%CI:1.39~1.83),n = 12,I2 = 58%]上均有统计学差异(P < 0.000 01)-根据检测时间不同进行亚组分析,结果提示术前-术中和术后组DTC阳性的乳腺癌患者比DTC阴性者预后差;根据检测方法不同进行亚组分析,用免疫细胞化学(immunocytochemistry,ICC)或逆转录定量聚合酶链反应(reverse transcriptanse quantitative polymerase chain reaction,RT-qPCR)方法检测DTC阳性与其阴性者相比,预后差异均有统计学意义(P < 0.000 01)-结论:术前-术中和术后DTC阳性的乳腺癌患者较DTC阴性者预后差-

    Abstract:

    Objective:To evaluate the prognostic relevance of disseminating tumor cells (DTCs) detection in the bone marrow of patients with breast cancer. Methods:The literature was searched from Medline,Embase,China National Knowledge Infrastructure (CNKI),Wanfang Data and VIP information database. Review Manager 5.1.4 was used for Meta-analysis and main outcome measures included progression-free survival (PFS) and overall survival (OS). Results:A total of 4 091 patients from 14 studies were enrolled. Meta-analysis associated the presence of DTCs with both poor PFS[HR=1.83(95%CI:1.51~2.22),n = 12,I2 = 75%]and OS[HR=1.59(95%CI:1.39~1.83),n = 12,I2 = 58%]. The subgroup analyses on different sampling time showed that the detection of DTCs was a potential prognostic factor before,during and after operation. Stratification by different detection methods also showed that there were statistically significant differences in PFS and OS between DTCs-positive patients and DTCs-negative ones both in iICC(immunocytochemistry) and RT-(q)PCR (reverse transcriptionanse quantitative polymerase chain reaction) compartment (P < 0.000 01). Conclusion:The presence of DTCs before,during and after operation indicates early recurrence and death in breast cancer patients.

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尹婧婧,周礼鲲,李鸿立,巴 一.骨髓微转移肿瘤细胞预测乳腺癌患者预后的Meta分析[J].南京医科大学学报(自然科学版),2012,(5):726-732

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  • 收稿日期:2012-02-07
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