There are inconsistent conclusions in the association between circulating tumor cells (CTCs) and urothelial cancer (UC). We performed a meta-analysis to assess the prognostic and diagnostic value of CTCs in UC. We search Medline, Embase and Web of science for relevant studies. The study was set up according to the inclusion/exclusion criteria. 30 published studies with a total of 2161 urothelial cancer patients were included. Meta-analysis showed that CTC-positive was significantly associated with tumor stage (≤ II vs III, IV) (OR = 4.60, 95% CI: 2.34–9.03), histological grade (I, II vs III) (OR = 2.91, 95% CI: 1.92–4.40), metastasis (OR = 5.12, 95% CI: 3.47–7.55) and regional lymph node metastasis (OR = 2.47, 95% CI: 1.75–3.49). It was also significantly associated with poor overall survival (OS) (HR = 3.98, 95% CI: 2.20–7.21), progression/disease-free survival (PFS/DFS) (HR = 2.22, 95% CI: 1.80–2.73) and cancer-specific survival (CSS) (HR = 5.18, 95% CI: 2.21–12.13). Overall sensitivity and specificity of CTC detection assays were 0.35 (95% CI: 0.28–0.43) and 0.97 (95% CI: 0.92–0.99) respectively. In summary, our meta-analysis suggests that the presence of CTCs in the peripheral blood is an independent predictive indicator of poor outcomes for urothelial cancer patients. It can also be used as a noninvasive method for the confirmation of cancer diagnosis. More studies are required to further explore the role of this marker in clinical practice.
Accurate determination of plasma human immunodeficiency virus type 1 (HIV-1) RNA levels is critical for the effective management of HIV-1 disease. The AMPLICOR HIV-1 MONITOR Test, a reverse transcription-PCR-based test for quantification of HIV-1 RNA in plasma, was developed when little sequence information on HIV-1 isolates from outside North America was available. It has since become apparent that many non-subtype B isolates, particularly subtypes A and E, are detected inefficiently by the test. We describe here the AMPLICOR HIV-1 MONITOR Test, version 1.5, an upgraded test developed to minimize subtype-related variation. We also developed a panel of HIV-1 standards containing 30 HIV-1 isolates of subtypes A through G. The virus particle concentration of each cultured viral stock was standardized by electron microscopic virus particle counting. We used this panel to determine the performance of the original AMPLICOR HIV-1 MONITOR Test and version 1.5 of the test with HIV-1 subtypes A through G. The original test underestimated the concentration of HIV-1 subtype A, E, F, and G RNA by 10-fold or more, whereas version of the 1.5 test yielded equivalent quantification of HIV-1 RNA regardless of the subtype. In light of the increasing intermixing of HIV-1 subtypes worldwide, standardization of PCR-based tests against well-characterized viral isolates representing the full range of HIV-1 diversity will be essential for the continued utility of these important clinical management tools.
Background and Objective: Forkhead box P3 (FoxP3) is known as the specific marker for regulatory T lymphocytes (Tregs), which are responsible for self-tolerance and disturb the antitumor immunity. However, the prognostic implication of tumor-infiltrating FoxP3+ Tregs in patients with colorectal cancer (CRC) still remains controversial. The aim of this present study was to investigate the prognostic role of FoxP3+ Tregs in CRC through meta-analysis.Methods: PubMed, Embase and Web of Science were searched for relevant articles up to December 12, 2016. Pooled hazard ratio (HR) and 95% confidence interval (CI) were calculated to explore the prognostic value of FoxP3+ Tregs in CRC. Odds ratio (OR) was calculated to investigate the correlation between FoxP3+ Tregs and pathological parameters.Results: A total of 18 studies comprising 3,627 patients with CRC were enrolled in our meta-analysis. The combined HR for FoxP3+ Tregs on cancer-specific survival was 0.70 (95% CI = 0.62–0.80, P < 0.001). High FoxP3+ Tregs level was also associated with favorable prognosis on overall survival (HR = 0.76, 95% CI = 0.58–1.01, P = 0.058), with P-value very close to the statistical threshold. Yet, there was no correlation between FoxP3+ Tregs infiltration and disease-free survival (HR = 0.83, 95% CI = 0.63–1.09, P = 0.182). Moreover, FoxP3+ Tregs infiltration was significantly correlated with pT stage (OR = 0.50, 95% CI = 0.39–0.65, P < 0.001), tumor grade (OR = 0.77, 95% CI = 0.61–0.98, P = 0.032), lymphatic invasion (OR = 0.25, 95% CI = 0.07–0.89, P = 0.033) and vascular invasion (OR = 0.67, 95% CI = 0.52–0.86, P = 0.001).Conclusion: The present meta-analysis suggests that high FoxP3+ Tregs infiltration is inclined to indicate favorable prognosis and is associated with the pathogenesis of CRC. Immunotherapy targeting Tregs in patients with CRC should be further investigated.
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