The prognostic value of circRNAs for gastric cancer: A systematic review and meta-analysis

Gastric cancer is the third leading cause of cancer-related deaths worldwide. Novel biomarkers circRNAs can play an important role in the development of gastric cancer as oncogenes or tumor suppressor genes. The purpose of this study was to clarify the relationship between the abnormal expression of multiple circRNAs and their prognostic value in gastric cancer patients through a meta-analysis. We researched articles reporting the relationship between circRNAs and the prognosis of gastric cancer published in PubMed, Cochrane, Embase, Web of Science, Wanfang, CNKI, and VIP databases before 31 December 2019. Thirty-five articles were selected for the meta-analysis, involving 3135 gastric cancer patients. The total HR values (95% CI) of OS and DFS related to highly expressed circRNAs that indicated worse prognosis were 1.83 (1.64-2.03; p < 0.001) and 1.66 (1.33-2.07; p < 0.001), respectively. The total HR (95% CI) of OS and DFS related to highly expressed circRNAs that indicated better prognosis was 0.54 (0.45-0.66; p < 0.001) and 0.58 (0.43-0.78; p < 0.001), respectively. Two panels of five circRNAs predicted a more considerable HR value (circ_0009910, hsa_circ_0000467, hsa_circ_0065149, hsa_circ_0081143, and circDLST; and circSMARCA5, circLMTK2, hsa_circ_0001017, hsa_circ_0061276, and circ-KIAA1244). The results of the meta-analysis were 2.63 (2.08-3.33; p < 0.001) and 0.39 (0.27-0.59; p < 0.001) for OS, respectively. The two panels of dysregulated circRNAs can be considered as more suitable potential prognostic tumor biomarkers in patients with gastric cancer because of their larger HR values.