title: The Prognostic Value of HER2-Positive Circulating Tumor Cells in Breast Cancer Patients: A Systematic Review and Meta-Analysis.
abstract: A meta-analysis was conducted to determine the prognostic value of HER2-positive circulating tumor cells (CTCs) in patients with breast cancer.
  
  
  
  MedLine, Central, and Embase databases were searched. Inclusion criteria were: (1) randomized controlled trials, 2-arm prospective studies, and retrospective studies; (2) patients with breast cancer; (3) HER2-positive CTCs were examined; and (4) hazard ratio (HR) of survival between patients with HER2-positive and HER2-negative CTCs was reported.
  
  
  
  Four studies with a total of 550 patients with stage I to IV breast cancer were included. HER2-positive CTCs were not associated with worse overall survival (OS; HR, 1.489, 95% confidence interval [CI], 0.873-2.540, P = .144) or progression-free survival (PFS; HR, 1.543; 95% CI, 0.636-3.744; P = .338). In patients without metastasis, HER2-positive CTCs were associated with worse OS (HR, 2.273; 95% CI, 1.340-3.853; P = .002) and worse PFS (HR, 2.870; 95% CI, 1.298-6.343; P = .009). There was no significant relationship between HER2-positive CTCs and survival in subgroups of patients with metastasis.
  
  
  
  HER2-positive CTCs have prognostic value in patients with breast cancer and without distant metastasis.
authors.affiliation: Division of Hematology/Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung and Chang Gung University, College of Medicine, Tao-Yuan, Taiwan. Electronic address: chwang@cgmh.org.tw.
authors.forename: Cheng-Hsu
authors.initials: CH
authors.lastname: Wang
authors.affiliation: Clinical Information and Medical Statistics Research Center for Clinical, Chang Gung University, Tao-Yuan, Taiwan.
authors.forename: Chee-Jen
authors.initials: CJ
authors.lastname: Chang
authors.affiliation: Division of Hematology/Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung and Chang Gung University, College of Medicine, Tao-Yuan, Taiwan.
authors.forename: Kun-Yun
authors.initials: KY
authors.lastname: Yeh
authors.affiliation: Division of Hematology/Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung and Chang Gung University, College of Medicine, Tao-Yuan, Taiwan.
authors.forename: Pei-Hung
authors.initials: PH
authors.lastname: Chang
authors.affiliation: Division of Hematology/Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung and Chang Gung University, College of Medicine, Tao-Yuan, Taiwan.
authors.forename: Jen-Seng
authors.initials: JS
authors.lastname: Huang
mesh_terms: D014408:Biomarkers, Tumor / Q000097:blood*; D001943:Breast Neoplasms / Q000097:blood* / Q000473:pathology*; D005260:Female; D006801:Humans; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000097:blood*
chemical_list: D014408:Biomarkers, Tumor; D018719:Erb-b2 Receptor Tyrosine Kinases; C508053:ERBB2 protein, human
keywords: Metastatic breast cancer; Non-metastatic breast cancer; Progression-free survival; Survival; Therapy resistance