title: [Prognostic value of circulating tumor cells and disseminated tumor cells in patients with esophageal cancer: a meta-analysis].
abstract: OBJECTIVE
  To explore the correlations of circulating tumor cells (CTCs) and disseminated tumor cells (DTCs) with the clinicopathological characteristics, prognostic events, and survival outcomes in esophageal cancer (EC) patients.
  
  
  METHODS
  The PubMed, Web of Science, Embase database and Cochrane database were searched for studies reporting the outcomes of interest. The studies were selected according to established inclusion/exclusion criteria. Meta-analysis of the studies was performed using Review Manager 5.3 and Stata12.0 software with the odds ratio (OR), risk ratio (RR) , hazard ratio (HR) , and 95% confidence interval (95% CI) as the effect indexes.
  
  
  RESULTS
  Nineteen studies involving a total of 1766 patients were included in the analysis. Significant correlations of CTCs and DTCs were found with the clinicopathological parameters including the tumor stage (OR=1.95), depth of invasion (OR=1.99), lymph node metastasis (OR=2.44SEN), distal metastasis (OR=5.98SEN), histological differentiation (OR=1.67) and lymphovascular invasion (OR=4.48). CTCs and DTCs were also correlated with the prognostic events including relapse (RR=6.86SEN) and metastasis (RR=3.22) and with the survival outcomes including the overall survival (OS) overall analysis (HR=3.46) and disease-free survival/progression-free survival (DFS/PFS) overall analysis (HR=3.00).
  
  
  CONCLUSIONS
  CTCs and DTCs are significantly associated with an advanced tumor stage, depth of tumor invasion, lymph node metastasis, distant metastasis before therapy, differentiation, lymphovascular invasion, relapse and metastasis in patients with EC. They are also significantly correlated with a poorer survival for OS and DFS/PFS to serve as clinical and prognostic predictors in patients with EC.
authors.affiliation: Department of Pathology, School of Basic Medical Sciences, Department of Epidemiology, Southern Medical University, Guangzhou 510515, China. E-mail: shixiaoxin1119@163.com.
authors.forename: Xiao-Xin
authors.initials: XX
authors.lastname: Shi
authors.forename: Jian-Hong
authors.initials: JH
authors.lastname: An
authors.forename: Ye-En
authors.initials: YE
authors.lastname: Huang
authors.forename: Yao-Zhong
authors.initials: YZ
authors.lastname: Zhang
authors.forename: Zhuo-Ya
authors.initials: ZY
authors.lastname: Huang
authors.forename: Zhen-Ning
authors.initials: ZN
authors.lastname: Zou
authors.forename: Qing
authors.initials: Q
authors.lastname: Chen
authors.forename: Hong
authors.initials: H
authors.lastname: Shen
mesh_terms: D018572:Disease-Free Survival; D004938:Esophageal Neoplasms / Q000175:diagnosis*; D006801:Humans; D008207:Lymphatic Metastasis; D009364:Neoplasm Recurrence, Local; D009360:Neoplastic Cells, Circulating; D016017:Odds Ratio; D011379:Prognosis; D016016:Proportional Hazards Models; D016019:Survival Analysis