Meta-analysis on Association of Circulating Tumor Cells with Prognosis in Gastric Cancer

Objective To study the relationship between lymph node metastasis, TNM stages, recurrence and overall survival with circulating tumor positive. Methods Embase, Medline and PubMed databases were searched by computer, based on inclusion and exclusion criteria for the screening literature. The research findings were extracted and evaluated by characteristics of selected literature. And all the results were tested for heterogeneity and data consolidation. Results Eighteen studies published between 2000 and 2011 matched to the selection criteria and were suitable for inclusion in this meta-analysis.There was a significantly higher incidence of circulating tumor cells (56.1%) in lymph node positive compared with negative groups (37.8%) ［RR=1.42,confidence interval (95%CI) =1.20~1.68］,and a significantly increased circulating tumor cells positive rate (36.7%) in TNM stage 1,2 compared with in stage 3 patients (56.6%) ［RR=0.63,95%CI:0.48~0.84］.Post-operative recurrence rate was significantly higher in the circulating tumor cell positive versus negative groups ［RR=2.42,95% CI:1.94~3.02］.Overall survival was significantly shorter in circulating tumor cells positive versus negative groups (HR=1.83,95%CI=1.30~2.60). Conclusion This study highlights the potential importance of circulating tumor cells detection in the peripheral blood of gastric cancers as a prognostic indicator and might benefit to the strategy of treatment.