Meta-analysis Of The Prognostic Value Of Circulating Tumor Cells In Non-metastatic Breast Cancer

Objective:To assess the prognostic value of circulating tumor cells(CTCs) in non-metastatic breast cancer patients. To conduct a Meta-analysis for the related studies about the relevance between CTCs and non-metastatic breast cancer.Methods:The Meta-analysis was conducted based on standard of the systematic review and analyse (MOOSE statement). We electronically searched PubMed, Web of science, SpringerLink, EMbase, WanFang Data, CNKI, VIP and CBM databases for cohort studies about the prognostic relevance of CTCs in the peripheral blood of stage Ⅰ to Ⅲ breast cancer patients from inception to April25rd 2014. The references of published literatures were also searched manually. Two reviewers independently screened studies according to the inclusion and exclusion criteria, extracted data and assessed methological quality based on Newcastle-Ottawa Scale. Meta-analysis was conducted using RevMan 5.2 software. Subgroup analysis was conducted according to the time of CTCs detecting and publication bias were assessed finally.Results:A total of 7 studies including 1780 patients were eligible for final analyses. Meta-analyses associated the presence of CTCs with both poor DFS (RR=2.24,95%CI 1.92 to 2.61, P<0.00001) and OS (RR=2.55,95%CI 1.99 to 3.28, P<0.00001).The subgroup analysis by detection time of CTCs showed that CTCs detected before and after adjuvant chemotherapy was a statistically significant prognostic factor.Conclusion:CTCs is an adverse prognostic factor in non-metastatic breast cancer patients, which is not significantly influenced by adjuvant chemotherapy. But multi-center and prospective big studies are needed to conducted to ensure the results, because the amount of the included studies was small.