A meta-analysis of the value of circulating tumor cells in monitoring postoperative recurrence and metastasis of colorectal cancer

Abstract

Objective Circulating tumor cells (CTCs) as novel biomarkers are widely investigated in various cancers, although most of the literature shows that CTCs have predictive value for recurrence, metastasis, and prognosis after CRC surgery, results remain controversial. We aimed to systematically evaluate the value of CTCs in monitoring of colorectal cancer (CRC) recurrence and metastasis after surgery. Method The PubMed, Cochrane Library, Embase, and other databases were searched from the establishment of the database to May 27, 2021. Relevant literature searches and data extraction were performed independently by two reviewers. The quality assessment was performed using the QUADAS2 scale developed by the Cochrane collaboration. The heterogeneity was checked using the Spearman correlation coefficient and the Cochran-Q test in the Meta-Disc1.4 software. Subgroup analysis was used to explore the source of heterogeneity. Considering that all the included papers were clinical studies with clinical heterogeneity, random effect model was adopted for analysis. And the sensitivity (Sen), specificity (Spe), positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and summary receiver operating characteristic (SROC) curves of CTCs, in monitoring recurrence and metastasis after CRC, were calculated. The publication bias of the included studies was assessed using Deek’s funnel figure. Result The literature included a total of 13 articles, comprising 1788 cases, and the overall quality of the literature was high. After summing up the indicators, the sensitivity pooled-value of the peripheral blood CTCs to monitor the recurrence and metastasis value of CRC after CRC was 0.67 [95%CI (0.62, 0.71)], specificity pooled-value was 0.71 [95%CI (0.67, 0.72)], PLR pooled-value was 2.37 [95%CI [1.52, 3.71]), NLR pooled into 0.53 [95%CI (0.36, 0.78)], DOR pooled into 4.97 [95%CI (2.11, 11.72)], AUC was 0.7395. Conclusion Peripheral blood CTCs have a moderate monitoring value for recurrence and metastasis after CRC; CTCs detected one week after surgery may be more correlated with recurrence and metastasis.

Prognostic value of circulating tumor cells in patients with recurrent and metastatic colorectal cancer: a systematic review and meta-analysis

“…Membrane-Arrays exhibited promise, combining time-efficiency, cost-effectiveness, and high-throughput capacity, [ 38 ] albeit with concerns raised by Wu’s analysis. [ 39 ] The value-added of our study lies in the integration of the China National Knowledge Infrastructure database, augmenting our research with additional subgroup analyses stratified by study design and research region. This methodological refinement enhances the depth and breadth of our investigation, ultimately yielding a more comprehensive body of evidence.…”

Current Applications and Future Directions of Circulating Tumor Cells in Colorectal Cancer Recurrence

“…In summary, CTC detection in the peripheral blood has the potential to become a prognostic factor for CRC recurrences [56,75,76] and disease progression [77]. The timing of blood tests can be applied at multiple points, including the time after surgery, since consecutive persisting CTCs or postoperative detection of CTCs implies a higher risk of cancer relapse.…”

Clinical application of liquid biopsy in colorectal cancer: detection, prediction, and treatment monitoring

“…CTCs are cells that fall off from primary tumors or recurrent sites and enter blood circulation. Therefore, the number of CTCs can predict PFS and overall survival (OS) in CRC patients [ 48 ]. As early as 2008, by setting the baseline CTCs to 3/7.5mL in 430 mCRC patients, the PFS and OS of patients above the baseline were shorter (PFS: 4.5 vs. 7.9 months; P = 0.0002; OS: 9.4 vs. 18.5 months; P < 0.0001) [ 49 ].…”