Meta-Analysis
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Nov 24, 2023; 14(11): 504-517
Published online Nov 24, 2023. doi: 10.5306/wjco.v14.i11.504
Circulating tumor cells as potential prognostic biomarkers for early-stage pancreatic cancer: A systematic review and meta-analysis
Zi-Han Zhang, Yi-Wen Bao, Ya-Jun Zhao, Jian-Quan Wang, Jin-Tao Guo, Si-Yu Sun
Zi-Han Zhang, Yi-Wen Bao, Ya-Jun Zhao, Jian-Quan Wang, Jin-Tao Guo, Si-Yu Sun, Department of Gastroenterology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
Author contributions: Zhang ZH contributed to the data acquisition and analysis, and article drafting; Bao YW, Zhao YJ, and Wang JQ and Sun SY oversaw acquiring and analyzing data; Guo JT was the study supervisor and was responsible for the revision of the manuscript; all authors read and gave their final approval for this version of the manuscript to be submitted.
Supported by Liaoning Province Applied Basic Research Program Joint Program Project, No. 2022JH2/101500076; Shenyang Young and Middle-aged Science and Technology Innovation Talent Support Program, No. RC200438; Tree planting program of Shengjing Hospital, No. M1595.
Conflict-of-interest statement: The authors deny any conflict of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jin-Tao Guo, MD, PhD, Professor, Department of Gastroenterology, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Shenyang 110004, Liaoning Province, China. guojt@sj-hospital.org
Received: June 28, 2023
Peer-review started: June 28, 2023
First decision: August 25, 2023
Revised: September 14, 2023
Accepted: October 26, 2023
Article in press: October 26, 2023
Published online: November 24, 2023
Processing time: 146 Days and 1.2 Hours
ARTICLE HIGHLIGHTS
Research background

Pancreatic cancer is a terribly invasive and poorly prognosis disease with a five-year survival less than 10%. Recently, more and more studies demonstrated that circulating tumor cells (CTCs) can be a significant prognostic marker of pancreatic cancer.

Research motivation

In this study, we conducted a meta-analysis to analyse the prognostic role of CTCs in patients with pancreatic cancer and investigated whether CTCs can provide prognostic information and assist develop personalized treatment plans.

Research objectives

Our research aims at exploring the predictive effect of CTCs on survival indicators of pancreatic cancer patients in different studies.

Research methods

A standardized literature search of databases was conducted for articles about CTCs published through December 2022. After screening based on inclusion and exclusion criteria, data relevant to prognosis were extracted for analysis. We used a fixed- or random-effect model to calculate the pooled hazard ratio (HR) and 95% confidence interval (CI) of overall survival (OS) and progression-free survival (PFS) according to the degree of heterogeneity.

Research results

Eight eligible studies with a total number of 355 patients with early-stage pancreatic cancer were included. This meta-analysis showed that positive pre-treatment or post-treatment CTCs was associated with shorter OS (HR = 1.93, 95%CI: 1.197-3.126, P = 0.007) and decreased relapse-free/disease-free/PFS (HR = 1.27, 95%CI: 1.137-1.419, P < 0.001) in patients with early-stage pancreatic cancer. While the CA19-9 level in the portal venous blood of early-stage pancreatic cancer patients showed no significant correlation with postoperative recurrence time of patients (HR = 1, 95%CI: 1.00-1.00, P = 0.03).

Research conclusions

Our meta-analysis indicates that CTCs are closely related to the prognosis of early pancreatic cancer patients and can serve as a guiding indicator for developing patient important treatment plans.

Research perspectives

Researchers should extend follow-up time to observe the relationship between CTC and OS. Besides, large-scale multicenter cohort studies are urgently needed to explore the full potential of CTCs.