Gao Yunhe, Zhang Kecheng, Xi Hongqing, Cai Aizhen, Wu Xiaosong, Cui Jianxin, Li Jiyang, Qiao Zhi, Wei Bo, Chen Lin
Chinese PLA General Hospital, Department of General Surgery, Beijing, 100853, People's Republic of China.
Oncotarget. 2017 Jan 24;8(4):6330-6340. doi: 10.18632/oncotarget.14064.
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.
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).
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.
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.
循环肿瘤DNA（ctDNA）为胃癌（GC）的检测和测量提供了一种微创方法。然而，其在胃癌中的诊断和预后价值仍不明确。
共有16项研究，包含1193例胃癌患者，符合我们的纳入标准。汇总的敏感性和特异性分别为0.62（95%置信区间（CI）0.59 - 0.65）和0.95（95%CI 0.93 - 0.96）。SROC曲线下面积（AUSROC）为0.94（95%CI 0.89 - 0.98）。结果表明，某些ctDNA标志物的存在与更大的肿瘤大小（OR：0.26，95%CI 0.11 - 0.61，p = 0.002）、TNM分期（I + II/III + IV，OR：0.11，95%CI 0.07 - 0.17，p = 0.000）以及幽门螺杆菌感染（H.p阴性/H.p阳性，OR：0.57，95%CI 0.36 - 0.91，p = 0.018）相关。此外，ctDNA的存在与较差的总生存期（HR 1.77，95%CI 1.38 - 2.28，p < 0.001）以及无病生存期（HR 4.36，95%CI 3.08 - 6.16，p < 0.001）之间也存在显著关联。
检索了Pubmed、Embase、Cochrane图书馆和Web of Science数据库，以获取截至2016年11月30日发表的相关文献。通过Meta - Disc软件汇总诊断准确性变量。使用Engauge Digitizer和Stata软件进行预后数据提取和分析。
我们的荟萃分析表明，检测某些ctDNA靶点与胃癌患者的不良预后显著相关，具有高特异性和相对中等的敏感性。
