Circulating tumour cells in pancreatic cancer: A systematic review and meta-analysis of clinicopathological implications

Tony C Y Pang; Joseph W Po; Therese M Becker; David Goldstein; Romano C Pirola; Jeremy S Wilson; Minoti V Apte

doi:10.1016/j.pan.2020.11.022

Circulating tumour cells in pancreatic cancer: A systematic review and meta-analysis of clinicopathological implications

Pancreatology. 2021 Jan;21(1):103-114. doi: 10.1016/j.pan.2020.11.022. Epub 2020 Dec 3.

Authors

Tony C Y Pang¹, Joseph W Po², Therese M Becker³, David Goldstein⁴, Romano C Pirola⁴, Jeremy S Wilson⁴, Minoti V Apte⁵

Affiliations

¹ Pancreatic Research Group, Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Australia; Surgical Innovations Unit, Westmead Hospital, Westmead, Australia; Westmead Clinical School, University of Sydney, Westmead, Australia.
² Centre for Circulating Tumour Cell Diagnostics and Research, Ingham Institute for Applied Medical Research, South Western Clinical School, University of New South Wales, School of Medicine, Western Sydney University, Australia; Surgical Innovations Unit, Westmead Hospital, Westmead, Australia; Westmead Clinical School, University of Sydney, Westmead, Australia.
³ Centre for Circulating Tumour Cell Diagnostics and Research, Ingham Institute for Applied Medical Research, South Western Clinical School, University of New South Wales, School of Medicine, Western Sydney University, Australia.
⁴ Pancreatic Research Group, Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Australia.
⁵ Pancreatic Research Group, Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Australia. Electronic address: m.apte@unsw.edu.au.

PMID: 33309014
DOI: 10.1016/j.pan.2020.11.022

Abstract

Background: The detection and quantification of circulating tumour cells (CTCs) in pancreatic cancer (PC) has the potential to provide prognostic information. The aim of this review was to provide an overview of the literature surrounding CTCs in PC.

Methods: A systematic literature review on CTCs in PC between 2005-2020 was performed. Data based on peripheral vein samples were used to determine the positivity rate of CTCs, their prognostic significance and their relative numbers compared to portal vein (PV) samples.

Results: The overall CTC detection rate in forty-four articles was 65% (95%CI: 55-75%). Detection rate for CellSearch was 26% (95%CI: 14-38%), which was lower than for both filtration and microfluidic techniques. In nine studies with >50 patients, overall survival was worse with CTC positivity (HR 1.82; 95%CI: 1.61-2.05). Five of seven studies which described PV CTC collection provided patient-level data. PV CTC yield was 7.7-fold (95%CI 1.35-43.9) that of peripheral blood.

Conclusions: CTCs were detected in the peripheral circulation of most patients with PC and may be related to prognosis and disease stage. PV blood contains more CTCs than peripheral blood sampling. This review points to the maturation of techniques of CTC enrichment, and its evidence base for eventual clinical deployment.

Keywords: Cancer staging; Cancer survival; Circulating tumour cells; Pancreatic cancer; Portal vein blood sampling.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

Humans
Neoplastic Cells, Circulating / pathology*
Pancreatic Neoplasms / blood*
Pancreatic Neoplasms / pathology*