title: Diagnostic and prognostic value of circulating tumor DNA in gastric cancer: a meta-analysis.
abstract: 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).
  
  
  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.
authors.affiliation: Chinese PLA General Hospital, Department of General Surgery, Beijing, 100853, People's Republic of China.
authors.forename: Yunhe
authors.initials: Y
authors.lastname: Gao
authors.affiliation: Chinese PLA General Hospital, Department of General Surgery, Beijing, 100853, People's Republic of China.
authors.forename: Kecheng
authors.initials: K
authors.lastname: Zhang
authors.affiliation: Chinese PLA General Hospital, Department of General Surgery, Beijing, 100853, People's Republic of China.
authors.forename: Hongqing
authors.initials: H
authors.lastname: Xi
authors.affiliation: Chinese PLA General Hospital, Department of General Surgery, Beijing, 100853, People's Republic of China.
authors.forename: Aizhen
authors.initials: A
authors.lastname: Cai
authors.affiliation: Chinese PLA General Hospital, Department of General Surgery, Beijing, 100853, People's Republic of China.
authors.forename: Xiaosong
authors.initials: X
authors.lastname: Wu
authors.affiliation: Chinese PLA General Hospital, Department of General Surgery, Beijing, 100853, People's Republic of China.
authors.forename: Jianxin
authors.initials: J
authors.lastname: Cui
authors.affiliation: Chinese PLA General Hospital, Department of General Surgery, Beijing, 100853, People's Republic of China.
authors.forename: Jiyang
authors.initials: J
authors.lastname: Li
authors.affiliation: Chinese PLA General Hospital, Department of General Surgery, Beijing, 100853, People's Republic of China.
authors.forename: Zhi
authors.initials: Z
authors.lastname: Qiao
authors.affiliation: Chinese PLA General Hospital, Department of General Surgery, Beijing, 100853, People's Republic of China.
authors.forename: Bo
authors.initials: B
authors.lastname: Wei
authors.affiliation: Chinese PLA General Hospital, Department of General Surgery, Beijing, 100853, People's Republic of China.
authors.forename: Lin
authors.initials: L
authors.lastname: Chen
mesh_terms: D019540:Area Under Curve; D014408:Biomarkers, Tumor / Q000097:blood* / Q000235:genetics; D016009:Chi-Square Distribution; D000074141:Circulating Tumor DNA / Q000097:blood* / Q000235:genetics; D018572:Disease-Free Survival; D005260:Female; D016481:Helicobacter Infections / Q000382:microbiology; D016480:Helicobacter pylori / Q000302:isolation & purification; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D016017:Odds Ratio; D011237:Predictive Value of Tests; D012372:ROC Curve; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000097:blood* / Q000235:genetics / Q000473:pathology / Q000628:therapy; D013997:Time Factors; D016896:Treatment Outcome; D047368:Tumor Burden
chemical_list: D014408:Biomarkers, Tumor; D000074141:Circulating Tumor DNA
keywords: ctDNA; diagnosis; gastric cancer; meta-analysis; prognosis