title: Diagnostic value of sentinel lymph node biopsy in gastric cancer: a meta-analysis.
abstract: BACKGROUND
  The possible application and validity of the sentinel lymph node (SLN) concept in gastric cancer (GC) is still debated. A systematic review to evaluate the diagnostic value of SLN biopsy (SLNB) in GC is urgently needed.
  
  
  METHODS
  A systematic review of relevant literatures was performed in PubMed, Embase, and The Cochrane Library. A random-effect model was used to pool the data, and subgroup analysis was used to explain the heterogeneities.
  
  
  RESULTS
  A total of 38 included studies (2,128 patients) were included. The pooled SLN identification rate, sensitivity, negative predictive value, and accuracy were 93.7% (95% confidence interval [95% CI]: 91.1-95.6%), 76.9% (95% CI: 71.6-81.4%), 90.3% (95% CI: 86.9-92.9%), and 92.0% (95% CI: 89.9-93.7%), respectively. Subgroup analysis showed that early T stage, combined tracers, submucosal injection method, conventional open surgery, and usage of immunohistochemistry were associated with higher SLN identification rate and sensitivity.
  
  
  CONCLUSIONS
  SLNB in GC is technically feasible with an acceptable sensitivity. However, further studies are needed to confirm the best procedure and standard criteria.
authors: Department of Gastrointestinal Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China. wangzhensurgeon@163.com
authors: Zhen
authors: Z
authors: Wang
authors: Zhi-Yong
authors: ZY
authors: Dong
authors: Jun-Qiang
authors: JQ
authors: Chen
authors: Jin-Lu
authors: JL
authors: Liu
mesh_terms: D016001:Confidence Intervals; D005240:Feasibility Studies; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis / Q000473:pathology; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D021701:Sentinel Lymph Node Biopsy / Q000592:standards*; D013274:Stomach Neoplasms / Q000473:pathology*