Abstract
BackgroundDNA aneuploidy has attracted growing interest in clinical practice. Nevertheless, its prognostic value in gastric cancer patients remains controversial. This meta-analysis aims to explore the impact of DNA ploidy status on the survival of gastric cancer patients.MethodsWe used PubMed and Web of Science databases to retrieve relevant articles. The correlation between DNA aneuploidy and the clinicopathological features of gastric cancer, such as stage, depth of invasion (T), lymph node metastasis (N), distant metastasis (M), differentiation (G), tumor types (Lauren classification) and overall survival (OS) were evaluated. Hazard ratios (HRs) with corresponding 95% confidence intervals (CIs) were collected carefully from each article OS was presented with HRs. The relationships between DNA aneuploidy and each characteristic were analyzed using risk ratios (RR) and a 95% confidence interval (CI). Significance was established using P < 0.05. Funnel plot was conducted to detect the publication bias.ResultsAfter careful selection, 25 studies involving 3449 cases were eligible for further analyses. Patients with DNA aneuploidy were considered at risk of more advanced stages (stage III-IV vs. stages I-II, RR = 1.23; 95% CI, 1.07 to 1.42; P = 0.003), lymph node metastasis (N+ vs. N-: RR = 1.43; 95% CI, 1.12 to 1.82, P = 0.004), and intestinal tumor type (intestinal vs. diffuse: RR = 1.45; 95% CI, 1.02 to 2.06; P = 0.04). And an adverse relation was observed between DNA aneuploidy and tumor differentiation. While no association was found between DNA aneuploidy and distant metastasis (P = 0.42) nor depth of tumor invasion (P = 0.86). Regarding overall survival, aneuploid tumors were associated with worse survival in all patients (P < 0.00001).ConclusionsWe found that DNA aneuploidy was an important predictor for gastric cancer patients, and should be used as a potential biomarker for further classification in gastric cancer.
Highlights
DNA aneuploidy has attracted growing interest in clinical practice
Literature search According to the search strategy, 98 studies were identified for full text review, in which 25 studies [10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34] possessed sufficient data for following meta-analyses (Fig. 1)
Additional file 1: Table S1 displayed the specific characteristics of each meta-analysis
Summary
DNA aneuploidy has attracted growing interest in clinical practice. Its prognostic value in gastric cancer patients remains controversial. This meta-analysis aims to explore the impact of DNA ploidy status on the survival of gastric cancer patients. Xu et al BMC Cancer (2019) 19:650 aneuploidy reflected a high genotypic instability, leading to malignant behavior of cells. Numerous articles which investigated DNA aneuploidy in various cancers have been published. Its role in non-small cell lung cancer, colorectal cancer and breast cancer seems clear. It was observed that patients with DNA aneuploid tumor had worse clinical outcomes in non-small cell lung cancer, colorectal cancer and breast cancer [6,7,8,9]
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