| Objective:Investigating the correlation between the clinicopathological characteristics of GC patients and recurrence after curative resection with the method of Meta analysis.Methods: The intersecting retrieval method is used by system retrieval and manual retrieval.A systematic search was performed using databases PubMed,Embase and Cochrane Library to identify relevant studies published in English,without publication date restriction.Meanwhile,references of relevant publications were manually searched for additional potentially relevant published studies.Screening the literatures retrieved in strict accordance with the inclusion criteria and the exclusion criteria,the odds ratio(OR),Standardized Mean Difference(SMD)and 95%confidence interval(CI)of total effect were calculated by Stata 12.0 statistical software.And then we could make dichotomous and continuous Meta analysis by using fixed or random effect model.Heterogeneity was assessed using Q-test,and I2 statistics.Results were presented using forest plots.Galbraith method was used to analysis the predominant source of heterogeneity originating.An influence analysis was performed to ascertain the results of the meta analysis by excluding each of the individual studies.Publication bias was assessed by the Egger method or the funnel plots of effect size versus standard error appeared symmetrical.Results: A total of 382 related literatures were screened out through systematic retrieval and manual retrieval.According to inclusion criteria and exclusion criteria,18 articles were included in our meta analysis.The final total sample size of gastric cancer was 18759 cases,of which there were 1010 patients with recurrence after curative gastrectomy and the recurrence rate was 5.38%.A total of 13 clinicopathological features were analyzed.Among them,histological type was also divided into WHO classification and Lauren's classification,gross type was also divided into depression type and non-depression type in EGC,Borrmann type IV and except Borrmann type IV in AGC,respectively.Then,the relationship between the factors and the recurrence of gastric cancer after radical gastrectomy was analyzed.The results showed that lymphatic invasion(OR=2.96,95%CI=[2.38,3.68],P= 0;I2=40.2%,P=0.081),tumor size(SMD=0.19,95%CI=[0.08,0.29],P= 0.001;I2=0.0%,P=0.731),tumor location(OR=1.25,95%CI=[1.02,1.54],P= 0.029;I2= 23.8%,P=0.203),histological type(WHO classification)(OR=0.85,95%CI=[0.74,0.98],P= 0.029;I2=39.0%,P=0.051),the depth of tumor invasion(OR=0.44,95%CI=[0.34,0.58],P= 0;I2=36.6%,P=0.137)have obvious correlation with the recurrence of gastric cancer.And there was no significant heterogeneity.Vascular invasion(OR=3.11,95%CI=[1.67,5.77],P= 0;I2=69.1%,P=0.000),Borrmann type(OR=2.94,95%CI=[1.40,6.17],P= 0.004;I2=74.1%,P=0.001),lymph node metastasis(OR=4.70,95%CI=[2.65,8.35],P= 0;I2=82.0%,P=0.000)have a statistically significant association with recurrence of gastric cancer,but there were higher heterogeneity.There was no significant correlation between sex,age,mode of operation,range of lymph node dissection,postoperative chemotherapy and recurrence of gastric cancer.the sources of heterogeneity could been explained by the Galbraith test.Sensitivity analysis of single evaluation results,the factors of meta stable analysis results,Egger s test to assess the publication bias,results in a correlation analysis of Lauren 's recurrent and gastric cancer has obvious publication bias and other factors meta analysis results were not published bias,reliable results.Conclusion: Lymphatic infiltration,tumor size,tumor location,histological type(WHO classification)and the depth of tumor invasion are the risk factors for recurrence of gastric cancer after radical gastrectomy.Therefore,it is recommended to strengthen follow-up monitoring and to develop more reasonable individualized treatment programs for patients with related risk factors. |
PDF Full Text Request