Cancer-associated fibroblasts, and clinicopathological characteristics and prognosis of gastric cancer: A systematic review and meta-analysis

Abstract

ObjectiveTo systematically evaluate the relationship between cancer-associated fibroblasts (CAFs) and clinicopathological characteristics and prognosis of gastric cancer, so as to provide new directions and clinical evidence for the diagnosis and treatment of this disease.MethodsWe searched PubMed, Embase, Web of Science, and The Cochrane Library to identify studies on the correlation between tumor-associated fibroblasts and the diagnosis and prognosis of gastric cancer. Two researchers screened the literature independently to extract data, evaluated the quality of the included studies, and used the Review Manager 5.4 software to perform a meta-analysis.ResultsA total of 14 studies involving a total of 2,703 patients were included. The meta-analysis results showed that high expression of CAFs was associated with stage III–IV gastric cancer (relative risk ratio [RR]=1.59; 95% confidence interval [CI]: [1.24–2.04]; P=0.0003), lymph node metastasis (RR=1.51; 95% CI: [1.23–1.87]; P=0.0001), serosal infiltration (RR=1.56, 95% CI: [1.24–1.95]; P=0.0001), diffuse and mixed types in Lauren classification (RR=1.43; 95% CI: [1.18–1.74]; P=0.0003), vascular invasion (RR=1.99; 95% CI: [1.26–3.14]; P=0.003), and overall survival (hazard ratio [HR]=1.38; 95% CI: [1.22–1.56]; P<0.00001). However, the high expression of CAFs was not significantly correlated with poorly differentiated gastric cancer (RR=1.03; 95% CI: [0.96–1.10]; P=0.45) and gastric cancer with tumor diameter >5 cm (RR=1.34; 95% CI: [0.98–1.83]; P=0.07).ConclusionThe findings of this meta-analysis demonstrated that high expression of CAFs is closely associated with the traditional pathological indicators related to poor prognosis in gastric cancer, and is a valuable prognostic factor in this setting.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022358165.

Diagnostic Performance of Positron Emission Tomography with Fibroblast-Activating Protein Inhibitors in Gastric Cancer: A Systematic Review and Meta-Analysis

“…According to this classification, intestinal GC is further divided into the tubular and glandular subtypes, which might show different levels of dedifferentiation. The diffuse variant is distinguished by weakly cohesive cells that lack glandular development and includes GC with signet ring cells, which is currently classified as a poorly cohesive form of GC, with tumor cells characterized by prominent cytoplasmic mucin and an eccentrically positioned crescent-shaped nucleus [ 5 ].…”

“…In recent years, most of the literature has enhanced a crucial concept: cancer is not restricted to malignant tumor cells alone, as it is characterized by a fundamental imbalance of the entire cell environment (TME), which is a complex dynamic system made up of cellular and non-cellular components [ 5 ]. Cancer-associated fibroblasts (CAFs) are stromal cells found lacking in epithelial, endothelial, or leukocyte markers, and, more importantly, oncogene mutations [ 9 ].…”