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Systematic Review ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Oncol. | doi: 10.3389/fonc.2019.01222

Association between liquid biopsy and prognosis of gastric cancer patients: a systematic review and meta-analysis

 Yunhe Gao1, 2, Hongqing Xi1, Bo Wei1, Jianxin Cui1,  Kecheng Zhang1, Hua Li3, Aizhen Cai1,  Weisong Shen1, 4, Jiyang Li1,  Rafael Rosell5,  Jesph Chao6,  Tianhui Chen7,  Samuel J. Klempner8, Zhi Qiao1* and  Lin Chen1, 9*
  • 1Department of General Surgery, Chinese PLA General Hospital, China
  • 2General Surgery Institute, PLA General Hospital, China
  • 3Department of Surgical oncology, Xingtai City People's Hospital Hospital, China
  • 4Nanjing General Hospital of Nanjing Military Command, China
  • 5Catalan Institute of Oncology, Germans Trias i Pujol Health Science Research Institute (IGTP), Spain
  • 6Department of Medical Oncology and Therapeutics Research, City of Hope National Medical Center, United States
  • 7Group of Molecular Epidemiology &Cancer Precision Prevention, Zhejiang Academy of Medical Sciences, China
  • 8The Angeles Clinic and Research Institute, United States
  • 9PLA General Hospital, China

Background: Reports regarding liquid biopsy and gastric cancer (GC) have emerged rapidly in recent decades, yet their prognostic value still remains controversial. This study was aimed to assess the impact of liquid biopsy, including circulating tumor cells (CTCs) and cell-free nucleic acids, on GC patients’ prognosis.
Methods: Pubmed, Medline, EMBASE, or ClinicalTrial.gov databases were searched for studies that reporting GC patient survival data stratified by CTC/circulating tumor DNA(ctDNA)/circulating miRNAs’ status. The hazard ratios (HRs) and their 95% confidence intervals (CIs) for patients’ overall survival (OS) and disease-free survival (DFS)/progression-free survival (PFS) were recorded or calculated depending on circulating targets status.
Results: We initially identified 4221 studies, from which 43 were eligible for further analysis, comprising 3814 GC patients. Pooled analyses showed that detection of certain CTCs, ctDNA and circulating miRNA, was associated with poorer overall survival (CTCs: HR=1.84, 95%CI 1.50-2.26, p<0.001; ctDNA: HR=1.78, 95%CI 1.36-2.34, p<0.001; circulating miRNA: HR=1.74, 95%CI 1.13-2.69, p<0.001) and disease-free survival/progression-free survival (CTCs: HR=3.39, 95%CI 2.21-5.20, p<0.001; ctDNA: HR=2.38, 95%CI 1.31-4.32, p=0.004; circulating miRNA: HR=3.30, 95%CI 2.39-4.55, p<0.001) of GC patients, regardless of disease stage and time point at which sample is taken (at baseline or post treatment).
Conclusions: The presence of CTCs and/or cellular components identifies a group of GC with poorer prognosis. Among circulating markers, CTCs demonstrated a stronger and more stable predictive value for late-stage disease and among Mongolian populations with GC. Less data is available for ctDNA and miRNA, however, their presence may also reflect aggressive biology and warrants further prospective study.

Keywords: liquid biopsy, circulating tumor cells, circulating tumor DNA, Circulating mRNA, gastric cancer, prognosis

Received: 24 Apr 2019; Accepted: 25 Oct 2019.

Copyright: © 2019 Gao, Xi, Wei, Cui, Zhang, Li, Cai, Shen, Li, Rosell, Chao, Chen, Klempner, Qiao and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Prof. Zhi Qiao, Department of General Surgery, Chinese PLA General Hospital, Beijing, China, drqiaozhi@126.com
Prof. Lin Chen, PLA General Hospital, Beijing, China, chenlin@301hospital.com.cn