Utilizing circulating tumour DNA as a prognostic predictor of gastric cancer: a meta-analysis

<b>Background:</b> Circulating tumour DNA (ctDNA) has demonstrated robust diagnostic accuracy in several digestive cancers. However, the prognostic role of ctCDNA in gastric cancer (GC) is still controversial. This systematic review and meta-analysis aimed to evaluate the prognostic value of ctDNA in GC. <b>Methods:</b> PubMed, Web of Science and Cochrane databases were searched to identify studies reporting the use of ctDNA to predict GC outcome and all relevant studies published until November 2022 were enrolled for our analysis. Data were extracted by two authors independently and statistic analysis was conducted by R program with ‘meta’ and ‘metafor’ packages. <b>Results:</b> A total of 34 qualified articles with 5091 subjects were incorporated into our meta-analysis. The corresponding Hazard ratio (HR) of overall survival (OS), disease-free survival (DFS) and progression-free survival (PFS) were 2.74 (95% CI:2.24–3.35), 3.13 (95% CI:2.08–4.72) and 3.04 (95% CI:2.46–3.76), respectively, in GC patients. <b>Conclusion:</b> Blood-based ctDNA assay would be a potential novel biomarker for GC evaluation and prediction. <b>Simple Summary:</b> This is the integrated meta-analysis on the association of circulating tumour DNA (ctDNA) and prognosis of gastric cancer (GC) with an increasing number of studies exploring the prognostic value of GC in the last few years, which depicted that the detection of ctDNA could be a promising predictor in GC patients.

<b>背景：</b>循环肿瘤DNA（circulating tumour DNA, ctDNA）在多种消化系癌症中已展现出可靠的诊断准确性。然而，ctDNA在胃癌（gastric cancer, GC）中的预后作用仍存在争议。本项系统评价与荟萃分析旨在评估ctDNA对胃癌的预后价值。<b>方法：</b>检索PubMed、Web of Science及Cochrane数据库，筛选报道利用ctDNA预测胃癌预后的相关研究，纳入截至2022年11月发表的全部符合要求的文献。由两名研究者独立提取数据，并使用搭载'meta'与'metafor'包的R程序开展统计分析。<b>结果：</b>本荟萃分析共纳入34篇合格研究，涉及5091名受试者。胃癌患者的总生存期（overall survival, OS）、无病生存期（disease-free survival, DFS）及无进展生存期（progression-free survival, PFS）对应的风险比（Hazard ratio, HR）分别为2.74（95%置信区间CI:2.24–3.35）、3.13（95% CI:2.08–4.72）与3.04（95% CI:2.46–3.76）。<b>结论：</b>基于血液的ctDNA检测有望成为胃癌评估与预后预测的新型潜在生物标志物。<b>简要概述：</b>近年来探索胃癌预后价值的研究数量不断增加，本研究针对循环肿瘤DNA（ctDNA）与胃癌预后的相关性开展了整合荟萃分析，结果显示ctDNA检测可作为胃癌患者颇具前景的预后预测指标。