Diagnostic and prognostic value of circulating tumor DNA in gastric cancer: a meta-analysis
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Yunhe Gao1,*, Kecheng Zhang1,*, Hongqing Xi1,*, Aizhen Cai1, Xiaosong Wu1, Jianxin Cui1, Jiyang Li1, Zhi Qiao1, Bo Wei1, Lin Chen1
1Chinese PLA General Hospital, Department of General Surgery, Beijing, 100853, People’s Republic of China
*These authors contributed equally to this work
Lin Chen, email: email@example.com
Keywords: ctDNA, gastric cancer, diagnosis, prognosis, meta-analysis
Received: September 26, 2016 Accepted: December 13, 2016 Published: December 21, 2016
Background: Circulating tumor DNA (ctDNA) has offered a minimally invasive approach for detection and measurement of gastric cancer (GC). However, its diagnostic and prognostic value in gastric cancer still remains unclear.
Results: A total of 16 studies comprising 1193 GC patients met our inclusion criteria. The pooled sensitivity and specificity were 0.62 (95% confidence intervals (CI) 0.59−0.65) and 0.95 (95% CI 0.93–0.96), respectively. The AUSROC (area under SROC) curve was 0.94 (95% CI 0.89–0.98). The results showed that the presence of certain ctDNA markers was associated with larger tumor size (OR: 0.26, 95% CI 0.11–0.61, p = 0.002), TNM stage (I + II/III + IV, OR: 0.11, 95% CI 0.07−0.17, p = 0.000), as well as H. pylori infection. (H.p negative/H.p positive, OR: 0.57, 95% CI 0.36–0.91, p = 0.018). Moreover, there was also a significant association between the presence of ctDNA and worse overall survival (HR 1.77, 95% CI 1.38−2.28, p < 0.001), as well as disease-free survival (HR 4.36, 95% CI 3.08−6.16, p < 0.001).
Materials and Methods: Pubmed, Embase, Cochrane Library and Web of Science databases were searched for relating literature published up until November 30, 2016. Diagnostic accuracy variables were pooled by the Meta-Disc software. Engauge Digitizer and Stata software were applied for prognostic data extraction and analysis.
Conclusions: Our meta-analysis indicates the detection of certain ctDNA targets is significantly associated with poor prognosis of GC patients, with high specificity and relatively moderate sensitivity.
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