ERS Respiratory Channel

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Abstract

Background: In lung cancer, the relevance of various CTC subgroups in different lung cancer subtypes is unclear. We performed a comprehensive meta-analysis to assess the prognostic value of CTCs in the different histologic types of lung cancer, with particular respect to CTC subtypes, cutoffs, and time points of CTC enumeration.

Methods: We searched Medline, Web of Science, and Embase alongside relevant studies evaluating the prognostic value of CTCs in lung cancer patients. A random effects model was used for meta-analysis, calculating hazard ratios (HRs), 95% confidence intervals (95% CIs), and p-values.

Results: A total of 27 studies enrolling 2957 patients were included. CTC detection indicates poor prognosis, especially in SCLC (small cell lung cancer) patients (OS: HR = 3.11, [95% CI: 2.59 ? 3.73]), and predicts a worse outcome compared to NSCLC (non-small cell lung cancer) patients. Epithelial CTCs predict a worse outcome for lung cancer than mesenchymal CTCs or epithelial-mesenchymal hybrids.

Conclusion: CTCs indicate poor prognosis in patients with primary lung cancer, with CTC in SCLC having a more pronounced prognostic effect. The prognostic value of CTCs detected by different markers varies; most evidence is available for the strong negative prognostic effect of epithelial CTCs.

Abstract

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