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Prognostic value of stem-like circulating tumor cells in patients with cancer: a systematic review and meta-analysis

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Abstract

Despite increasing interest in the study of circulating tumor cells (CTC) subsets, especially epithelial-mesenchymal transition (EMT) and stem cells subsets of CTC that play a key role in tumor recurrence and metastasis, there is no evidence from meta-analyses that shows the correlation between stem-like CTCs and prognosis in cancer patients. Thus, we performed a meta-analysis to assess its prognostic value. Sixteen articles were screened by searching the PubMed, Embase, Cochrane, China National Knowledge Internet (CNKI) and Wanfang databases. The hazard ratio (HR) and 95% confidence interval (95% CI) extracted from each article were summarized. Patients with positive stem-like CTCs in peripheral blood had significantly shorter overall survival (OS, HR: 2.58, 95% CI 1.76–3.79, P < 0.00001), progression-free survival (PFS, HR: 2.21, 95% CI 1.26–3.89, P = 0.006) and disease-free survival (DFS, HR: 2.53, 95% CI: 1.12–5.70, P = 0.03). This study provides the first meta-analysis evidence for the prognostic value of stem-like CTCs, demonstrating that these cells are associated with poor prognosis in cancer patients.

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Funding

This work is supported by the Chinese Academy of Medical Sciences (CAMS) Initiative for Innovative Medicine (Grant No: 2017-I2M-1-005) and the National Key R&D Program of China (Grant No. 2017YFC1308700, No. 2017YFC1308702).

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Authors and Affiliations

  1. State Key Laboratory of Molecular Oncology, Department of Etiology and Carcinogenesis, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China

    Qi Zhang, Defeng Kong, Zhenrong Yang, Guoliang Li, Shujun Cheng, Lin Feng & Kaitai Zhang

  2. Department of Immunology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China

    Wen Zhang

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  1. Qi Zhang
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Zhang and Zhang: concept and design; Zhang and Kong: collection and assembly of data; Zhang and Yang: data analysis and interpretation; all authors: manuscript writing and final approval of the manuscript.

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Correspondence to Kaitai Zhang or Wen Zhang.

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Zhang, Q., Kong, D., Yang, Z. et al. Prognostic value of stem-like circulating tumor cells in patients with cancer: a systematic review and meta-analysis. Clin Exp Med 23, 1933–1944 (2023). https://doi.org/10.1007/s10238-023-01009-0

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