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The prognostic role of circulating tumor cells (CTCs) detected by RT-PCR in breast cancer: a meta-analysis of published literature

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An Erratum to this article was published on 08 July 2011

Abstract

The prognostic significance of circulating tumor cells (CTCs) in patients with breast cancer is controversial. We performed a meta-analysis of published literature to assess whether the detection of CTCs in patients diagnosed with primary breast cancer can be used as a prognostic factor. We searched Medline, Science Citation Index, and Embase databases as well as reference lists of relevant articles (including review articles) for studies that assessed the prognostic relevance of tumor cell detection in the peripheral blood (PB). A total of 24 eligible studies with 4,013 cases and 1,333 controls were included. Meta-analyses were performed using a random-effects model, using the hazard ratio (HR) and 95% confidence intervals (95% CIs) as effect measures. The positive detection of CTCs in patients was significantly associated with poor overall survival (OS) (HR = 3.00 [95% CI 2.29–3.94], n = 17, P < 0.0001) and recurrence-free survival (RFS) (HR = 2.67 [95% CI 2.09–3.42], n = 22, P < 0.0001). CTC-positive breast cancers were significantly associated with high histological grade (HR = 1.21 [95% CI 1.09–1.35], n = 34, P < 0.0001), tumor size (>2 cm) (HR = 1.12 [95% CI 1.02–1.22], n = 31, P = 0.01). and nodal status (≥1) (HR = 1.10 [95% CI 1.00–1.21], n = 32, P = 0.037), but cytokeratin-19 (CK-19) mRNA-positive CTCs were not associated with these clinicopathological parameters of breast cancer. Furthermore, the presence of CTCs was not associated with estrogen receptor (ER) negativity, progesterone receptor (PR) negativity, or human epidermal growth factor receptor type 2 (HER2) positivity. Detection of CTCs in the PB indicates poor prognosis in patients with primary breast cancer. Larger clinical studies are required to further evaluate the role of these markers in clinical practice.

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Acknowledgments

This experiment was finished in the oncobiology key lab of the Heilongjiang common institution of higher learning. This work was supported by the National Natural Science Foundation of China [grant number 81071889].

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Authors and Affiliations

  1. Department of Internal Medicine, The Third Affiliated Hospital of Harbin Medical University, Haping Road 150 of Nangang District, Harbin, Heilongjiang Province, 150081, China

    Shu Zhao, Qingyuan Zhang, Hongbin Li, Minghui Zhang, Wenjie Ma, Wenhui Zhao, Jingxuan Wang & Maopeng Yang

  2. Department of Epidemiology, Public Health College of Harbin Medical University, Harbin, Heilongjiang Province, China

    Yupeng Liu

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  1. Shu Zhao
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Correspondence to Qingyuan Zhang.

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Shu Zhao and Yupeng Liu contributed equally to the work and should be considered co-first authors.

An erratum to this article can be found at http://dx.doi.org/10.1007/s10549-011-1659-z

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Zhao, S., Liu, Y., Zhang, Q. et al. The prognostic role of circulating tumor cells (CTCs) detected by RT-PCR in breast cancer: a meta-analysis of published literature. Breast Cancer Res Treat 130, 809–816 (2011). https://doi.org/10.1007/s10549-011-1379-4

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