Relationship Between Circulating Tumour Cells And The Clinicopathological Features And Prognosis Of Ovarian Cancer:A Meta-analysis

Objective:To analyze the relationship between the clinicopathological features and the prognosis of ovarian cancer and circulating tumor cells(CTCs)Methods:The relationship between CTCs and clinicopathological characteristics and prognosis of ovarian cancer patients in databases such as PubMed,EMBASE,CENTRAL(Cochrane Central Register of Controlled Trials),Wanfang and China Knowledge Network(CNKI)was systematically reviewd.The retrieval time was from establishment of each database to February 2019.The outcome indicators included clinical pathology parameters(histological GRADE classification,International Federation of Gynecology and Obstetrics(FIGO staging),lymph node Metastasis,cytoreductive surgery and treatment response),survival information(total survival OS,Progression free survival,disease free survival PFS/DFS)and CA125.Meta analysis was performed with Revman 5.0 software.The correlation between them is described by taking odds ratio(OR)as an indicator.Hazard ratio(HR)and95%Confidence Interval(CI)were used to describe survival information.Result:A total of 25 qualified literatures were included in this study,including 17 in English and 8 in Chinese.Meta-analysis results showed that:1.There was no significant correlation between CTCs and GRADE classification(OR=1.36,95%CI:0.98-1.88,p=0.06,I~2=0%);2.CTCs were significantly associated with FIGO stage(FIGO III-IV)(OR=3.22,95%CI:1.61-6.44,p=0.0009,I~2=60%);3.CTCs-positive patients with ovarian cancer have more than twice risk of lymph node metastasis as those with CTCs negative(OR=2.06,95%CI:1.27-3.34,p=0.004,I~2=0%);4.There was no significant correlation between CTCs and optimal OR suboptimal cytoreductive surgery(OR=1.64,95%CI:0.99-2.72,p=0.06,I~2=37%);5.Overall survival(OS)and progression-free/no disease-free survival(PFS/DFS)of CTCs-positive patients were shorter than those of CTCs-negative patients(OS:HR=1.44,95%CI:1.06-1.97,p=0.02,I~2=59%;PFS/DFS:HR=1.47,95%CI:1.22-1.77,p<0.0001,I~2=0%);6.CTCs have significant correlation with CA125 in patients(OR=2.55,95%CI:1.68-3.87,p<0.0001,I~2=0%).Conclusion:1.In terms of clinicopathology of ovarian cancer patients,this Meta-analysis found that compared with CTCs-negative patients,CTCs-positive patients had later FIGO stage and higher risk of lymph node metastasis,but there was no significant difference between the two groups in terms of GRADE stage and cytoreductive surgery.2.In terms of survival information,this Meta-analysis showed that the overall survival(OS)and progression-free/disease-free survival(PFS/DFS)of CTCs positive patients were shorter than those of CTCs negative patients.3.This Meta-analysis also found a significant correlation between CTCs and CA125 in patients.