Chen QX, Zeng WM, Zhang YB, Cai YC, Lv CB, Sun YQ, Cai LS. Preoperative circulating tumor cells as a prognostic indicator in gastric cancer. World J Gastrointest Oncol 2026; 18(3): 115664 [DOI: 10.4251/wjgo.v18.i3.115664]
Corresponding Author of This Article
Li-Sheng Cai, Adjunct Associate Professor, Chief Physician, Department of Gastric and Small Bowel Surgery, Zhangzhou Affiliated Hospital of Fujian Medical University, No. 59 West Shengli Road, Zhangzhou 363000, Fujian Province, China. wxccls2024@163.com
Research Domain of This Article
Oncology
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Mar 15, 2026 (publication date) through Mar 12, 2026
Times Cited of This Article
Times Cited (0)
Journal Information of This Article
Publication Name
World Journal of Gastrointestinal Oncology
ISSN
1948-5204
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Share the Article
Chen QX, Zeng WM, Zhang YB, Cai YC, Lv CB, Sun YQ, Cai LS. Preoperative circulating tumor cells as a prognostic indicator in gastric cancer. World J Gastrointest Oncol 2026; 18(3): 115664 [DOI: 10.4251/wjgo.v18.i3.115664]
Qiu-Xian Chen, Wei-Ming Zeng, Yong-Bin Zhang, Chen-Bin Lv, Yu-Qin Sun, Li-Sheng Cai, Department of Gastric and Small Bowel Surgery, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou 363000, Fujian Province, China
Yi-Chen Cai, School of Public Health, Xiamen University, Xiamen 361102, Fujian Province, China
Co-first authors: Qiu-Xian Chen and Wei-Ming Zeng.
Author contributions: Chen QX, Zeng WM, and Cai LS designed the study; Chen QX, Zeng WM, Lv CB and Sun YQ were responsible for developing the methodology; Chen QX, Zeng WM, Sun YQ, Zhang YB and Cai YC collected and analyzed data; Chen QX, Zeng WM, Sun YQ, Zhang YB and Cai YC performed statistical analysis; Chen QX and Zeng WM wrote the original draft; Cai LS, Chen QX, Zeng WM and Sun YQ participated in the review and editing. All authors approved the final version. Chen QX and Zeng WM contributed equally to this work as co-first authors.
Supported by Natural Science Foundation of Fujian Province, No. 2024J011567.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of Zhangzhou Hospital Affiliated to Fujian Medical University, No. 2025 LWB252.
Informed consent statement: All patients provided written informed consent to participate in this study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: No additional data are available.
Corresponding author: Li-Sheng Cai, Adjunct Associate Professor, Chief Physician, Department of Gastric and Small Bowel Surgery, Zhangzhou Affiliated Hospital of Fujian Medical University, No. 59 West Shengli Road, Zhangzhou 363000, Fujian Province, China. wxccls2024@163.com
Received: October 22, 2025 Revised: December 1, 2025 Accepted: December 30, 2025 Published online: March 15, 2026 Processing time: 141 Days and 11 Hours
Abstract
BACKGROUND
Circulating tumor cells (CTCs) are promising minimally invasive biomarkers for tumor biology and metastasis. Although their clinical value has been established in several cancers, the evidence supporting their role in gastric cancer remains inconsistent and warrants further validation.
AIM
To investigate the prognostic value of preoperative CTCs detection in patients with gastric cancer.
METHODS
A retrospective analysis of patients with pathologically confirmed gastric adenocarcinoma who underwent preoperative testing of peripheral blood CTCs at the Department of Gastric and Small Intestinal Surgery, Zhangzhou Hospital, Fujian Province between June 2020 and March 2021 was performed. Correlations between preoperative CTCs status and clinicopathological characteristics as well as prognosis were evaluated.
RESULTS
Among the 115 patients newly diagnosed with gastric cancer, 61 (53.04%) were CTCs-positive and 54 (46.96%) were CTCs-negative. Significant differences were observed between the CTCs-positive and CTCs-negative groups in terms of tumor differentiation, lymph node metastasis, distant metastasis, pathologic tumour, node, and metastasis stage, and coagulation parameters (activated partial thromboplastin time, thrombin time, D-dimer level, and platelet count) (all P < 0.05). However, no significant differences were found in age, sex, body mass index, tumor size, tumor location, depth of invasion, neural invasion, vascular invasion, or other coagulation markers (prothrombin time and fibrinogen) (all P > 0.05). Univariate Cox regression analysis identified tumor size, depth of invasion, lymph node and distant metastases, tumor stage, neural invasion, vascular invasion, and CTCs positivity as risk factors for poor prognosis in patients with gastric cancer. At the follow-up cutoff date, recurrence or metastasis had occurred in 28 CTCs-positive patients (45.90%) and 15 CTCs-negative patients (27.78%). The CTCs-positive group exhibited higher rates of distant metastasis (78.57% vs 66.67%, P = 0.394) and peritoneal metastasis (64.29% vs 46.67%, P = 0.264) than the CTCs-negative group. Additionally, the CTCs-positive group had significantly shorter progression-free survival (PFS) (32.72 months vs 39.96 months, P = 0.036) and a trend toward reduced overall survival (38.62 months vs 41.11 months, P = 0.411).
CONCLUSION
Preoperative CTCs detection is associated with aggressive biological behavior in gastric cancer and has predictive value for PFS. Based on these findings, we recommend integrating preoperative CTCs testing into the clinical management of patients to improve risk stratification and guide personalized treatment strategies. Further prospective studies are warranted to validate the utility of optimizing surveillance protocols and therapeutic decisions.
Core Tip: This study demonstrates that preoperative detection of circulating tumor cells (CTCs) is a potent and minimally invasive prognostic tool for gastric cancer. We found that CTCs-positive status was significantly associated with aggressive clinicopathological features, including advanced tumor stage and metastasis. Importantly, CTCs positivity was an independent predictor of significantly shorter progression-free survival. These findings strongly support the integration of preoperative CTCs testing into standard clinical practice to enhance risk stratification and guide personalized treatment decisions for patients with gastric cancer.
Citation: Chen QX, Zeng WM, Zhang YB, Cai YC, Lv CB, Sun YQ, Cai LS. Preoperative circulating tumor cells as a prognostic indicator in gastric cancer. World J Gastrointest Oncol 2026; 18(3): 115664
Gastric cancer is the fifth most commonly diagnosed cancer and the third leading cause of cancer-related deaths in China[1]. Most patients are diagnosed at an advanced stage, with a five-year survival rate of approximately 30%. Recurrence and metastasis are key factors that contribute to the poor prognosis of patients with gastric cancer[2-4]. Therefore, the early detection of tumor recurrence and timely clinical intervention are crucial for improving patient survival. However, conventional methods such as serum tumor markers, computed tomography, magnetic resonance imaging, and positron emission tomography-computed tomography lack sufficient sensitivity to accurately identify micrometastases at an early stage[5-7]. Hence, there is an urgent need to develop novel, sensitive, and efficient detection methods to facilitate disease assessment, monitoring of recurrence and metastasis, and prognostic evaluation in gastric cancer.
Circulating tumor cells (CTCs) are tumor cells that detach from the primary tumor and enter the peripheral circulation. They carry biological and genetic information similar to that of the original tumor tissue and play key roles in tumor progression, recurrence, and metastasis[8]. Previous studies have shown that CTCs are associated with unfavorable clinicopathological features in various malignancies, including breast, lung, and colorectal cancers, demonstrating their significant clinical value in disease monitoring, recurrence detection, and prognostic prediction[9-12]. A meta-analysis revealed that CTCs-positive breast cancer patients have significantly shorter progression-free survival (PFS) and overall survival (OS) than CTCs-negative patients[13]. Another meta-analysis including 18 cohort studies with 1321 patients with lung cancer also found that CTCs-positive patients had markedly reduced disease-free survival (DFS) [hazards ratio (HR) = 2.97, 95% confidence interval (CI): 2.08-4.22; P < 0.00001] and OS (HR = 3.53, 95%CI: 2.51-4.95; P < 0.00001) compared to the CTCs-negative group[14].
Global research on CTCs in gastric cancer is still in preliminary stages. Ning et al[15] found that CTCs positivity was associated with poorer PFS and OS in gastric cancer (P < 0.001). In contrast, Li et al[16] reported that CTCs positivity was correlated with DFS (P = 0.002) but not with OS (P = 0.074). These inconsistent findings indicate that the clinical utility of CTCs in gastric cancer requires further validation through additional studies.
This real-world study aimed to investigate the correlation between preoperative CTCs status and clinicopathological characteristics as well as prognosis in patients with gastric cancer, with the goal of providing evidence-based support for the application of CTCs in gastric cancer management.
MATERIALS AND METHODS
Study population
We enrolled patients with pathologically confirmed gastric adenocarcinoma who underwent surgical resection at the Department of Gastrointestinal Surgery, Zhangzhou Affiliated Hospital of Fujian Medical University between June 2020 and March 2021. Peripheral blood was collected from all patients before surgery for CTCs detection. Postoperative pathological staging was performed according to the 8th edition of the American Joint Committee on Cancer tumour, node, and metastasis (TNM) staging system for gastric cancer.
Eligibility criteria
Inclusion criteria: (1) Age between 18 and 85 years; (2) Preoperative gastroscopy and biopsy confirmed the diagnosis of gastric adenocarcinoma, and the patient was scheduled for surgery; (3) No prior antitumor therapy of any kind before surgery; and (4) No other organ malignancies.
Exclusion criteria: (1) Patients unable to tolerate surgery; (2) Pregnant or lactating women or those with positive pregnancy test results; (3) Concurrent surgical treatment for other diseases; and (4) Impaired function of major organs.
CTCs detection and positive criteria
Peripheral blood was collected from the median cubital vein of gastric cancer patients after overnight fasting. CTCs in the blood samples were detected within 24 hours by negative enrichment combined with immunofluorescence in situ hybridization (imFISH) for CEP8 and CEP17 (Jiangsu Lair Biomedicine Co., Ltd.)[16,17]. Criteria for identifying CTCs using fluorescence microscopy (DAPI stained blue; CEP8, orange; CEP17, green; and CD45, red) are as follows: (1) CD45(–), CEP8 > 2, and CEP17 = 2; (2) CD45(–), CEP8 = 2, and CEP17 > 2; and (3) CD45(–), CEP8 > 2, and CEP17 > 2.
Surgical management
All the surgeries were performed by experienced gastric surgeons in the same department. The surgical approach was determined based on tumor size, location, and intraoperative findings. After resection, surgical specimens were promptly processed by the surgeons for perigastric lymph node dissection and fixed for pathological examination.
Follow-up and survival outcomes
Follow-ups were conducted through outpatient visits, hospital readmissions, WeChat, and telephone interviews. All patients were followed up starting from the first day after surgery, every three months in the first and second years, and every six months thereafter. PFS was defined as the time from the date of surgery to the first occurrence of tumor recurrence, distant metastasis, or until the end of follow-up. OS was defined as the time from the date of surgery to death from any cause or until the end of follow-up. The CTCs-positive group had a median follow-up of 43.00 ± 0.45 months compared to 44.00 ± 1.06 months for the CTCs-negative group. The follow-up period ended on July 31, 2024.
Ethics approval and consent to participate
The study protocol complied with the ethical standards of the Declaration of Helsinki and was approved by the Ethics Committee of Zhangzhou Affiliated Hospital of Fujian Medical University (approval No. 2025 LWB252). All patients provided written informed consent to participate in the study.
Statistical analysis
Data analysis and graphing were performed using SPSS 25.0 and GraphPad Prism 8.0. Categorical data were described using frequencies and proportions. Comparisons between the groups were conducted using t-tests, analysis of variance, χ2 tests, or nonparametric tests, as appropriate. Survival analysis was performed using the Kaplan-Meier method, and comparisons were made using the log-rank test. Univariate analysis of prognostic factors was performed using Cox regression models. The HR and 95%CI were used to determine mortality risk. A P value < 0.05 was considered statistically significant.
RESULTS
Detection of CTCs
Based on the inclusion and exclusion criteria, 115 patients who underwent preoperative CTCs testing were enrolled in this study. Among them, 61 (53.04%) were CTCs-positive and 54 (46.96%) were CTCs-negative. Figure 1 shows representative staining patterns (Figure 1A-C) and CTCs-negative (Figure 1D) cases.
Association between CTCs positivity rate and clinicopathological characteristics of gastric cancer
Statistically significant differences were observed between the preoperative CTCs-positive and CTCs-negative groups in terms of tumor differentiation, lymph node metastasis, distant metastasis, pathologic TNM (pTNM) stage, and coagulation parameters, including activated partial thromboplastin time (APTT), thrombin time (TT), D-dimer, and platelet (PLT) count (all P < 0.05). However, no significant differences were found in age, sex, body mass index (BMI), tumor size, tumor location, depth of invasion, neural invasion, vascular invasion, or other coagulation parameters, such as prothrombin time (PT) and fibrinogen (FIB) (all P > 0.05) (Table 1).
Table 1 Association between circulating tumor cells status and clinicopathological characteristics in patients with gastric cancer, n (%).
Results of univariate cox analysis of risk factors affecting PFS in gastric cancer patients
Univariate Cox regression analysis revealed that tumor size, depth of invasion, lymph node metastasis, distant metastasis, tumor stage, perineural invasion, lymphovascular invasion, and positive CTCs were risk factors for poor prognosis in patients with gastric cancer (Table 2).
Table 2 Univariate COX analysis of risk factors affecting progression-free survival in gastric cancer patients.
Comparison of postoperative recurrence and metastasis between the two patient groups
By the end of the follow-up period, recurrence and metastasis had occurred in 28 patients (45.90%) in the CTCs-positive group and in 15 patients (27.78%) in the CTCs-negative group (Figure 2). The CTCs-positive group showed higher rates of distant (78.57% vs 66.67%; P = 0.394) and peritoneal metastases (64.29% vs 46.67%; P = 0.264) than the CTCs-negative group, but the differences were not statistically significant (Table 3). Detailed sites of recurrence and metastasis in the two patient groups are presented in Figure 2 and Tables 3, 4, and 5.
Comparison of survival outcomes between the two groups
No patient was lost to follow-up until the end of the study period. The CTCs-positive group had a median follow-up of 43.00 ± 0.45 months compared to 44.00 ± 1.06 months for the CTCs-negative group. The CTCs-positive group showed a significantly shorter PFS compared to the CTCs-negative group (32.72 months vs 39.96 months; P = 0.036). Twenty patients (32.79%) in the CTCs-positive group and 14 (25.93%) in the CTCs-negative group died during follow-up. Although the CTCs-positive group had a shorter median OS than the CTCs-negative group (38.62 months vs 41.11 months), the difference was not statistically significant (P = 0.411). Survival curves are shown in Figure 3.
Figure 3 Comparison of progression-free survival and overall survival between circulating tumor cells-positive and circulating tumor cells-negative groups using the Kaplan-Meier method.
A: Progression-free survival; B: Overall survival. CTCs: Circulating tumor cells; PFS: Progression-free survival; OS: Overall survival.
DISCUSSION
The results demonstrated that preoperative CTCs were significantly associated with tumor differentiation, lymph node metastasis, distant metastasis, pTNM stage, and coagulation parameters, including APTT, TT, D-dimer, and PLT. The CTCs-positive group showed a higher incidence of distant and peritoneal metastases after surgery. Survival analysis revealed that PFS was significantly shorter in the CTCs-positive group than in the CTCs-negative group.
In recent years, CTCs have emerged as important biomarkers for tumor burden monitoring, recurrence surveillance, and prognosis prediction in various solid tumors, including lung, breast, colorectal, and prostate cancers[18-22]. However, owing to variations in the detection methods and cutoff values used across studies, there is currently no established guideline or consensus defining a specific threshold for CTCs positivity. In breast cancer, a threshold of five CTCs is commonly adopted[23]. In gastric cancer, CTCs counts are generally lower than in breast cancer. In several studies on gastric cancer, Li et al[16] used a threshold of two CTCs and found a statistically significant difference in PFS between CTCs-positive and CTCs-negative patients; however, no significant difference was observed when a threshold of one CTCs was applied. In contrast, Uenosono et al[24] reported that patients with detectable CTCs (using a cut-off value of one) had significantly worse PFS and OS than those without detectable CTCs (P < 0.05). In the present study, a cutoff value of one CTCs per 3.2 mL of blood was used to define CTCs positivity. Based on this criterion, 61 patients (53.04%) were classified as CTCs-positive and 54 (46.96%) as CTCs-negative.
Tumor cells can enter the circulatory system via lymphatic and blood reflux through the gastric wall layers, leading to distant metastasis. Multiple studies have indicated a correlation between CTCs positivity and clinicopathological stage in gastric cancer. Zheng et al[25] reported that CTCs correlated with TNM and T stages (P < 0.05). Similarly, Hiraiwa et al[26] found that preoperative CTCs were significantly associated with the TNM stage in gastrointestinal cancer patients (P < 0.05). Uenosono et al[24] also demonstrated significant correlations between CTCs and depth of invasion, lymph node metastasis, distant metastasis, and TNM stage. In a meta-analysis of 2566 patients with gastric cancer across Asia, Europe, and Africa, CTCs positivity was significantly associated with clinicopathological parameters, TNM stage, vascular and lymphatic invasion, and tumor differentiation[27]. Our findings are consistent with these reports, showing significant differences in tumor differentiation, lymph node metastasis, distant metastasis, and pathological stage between the CTCs-positive and CTCs-negative groups (P < 0.05), whereas no significant differences were observed in age, sex, BMI, tumor size, tumor location, depth of invasion, neural invasion, and vascular invasion (P > 0.05). The variations in correlations among studies may be attributed to differences in CTCs detection methods, positivity thresholds, and sample sizes. Nevertheless, the overall evidence suggests that CTCs positivity is associated with poor differentiation, lymph node metastasis, distant metastasis, and advanced TNM stage.
In a prospective study by Zhang et al[28] involving 93 patients with resectable gastric cancer, CTCs were assessed before and after surgery. Patients with ≥ 5 CTCs before surgery had a significantly lower DFS compared to those with < 5 CTCs (40.0% vs 66.4%, P < 0.001). Similarly, postoperative CTCs counts ≥ 5 were associated with reduced DFS (25.0% vs 62.2%, P < 0.001). The mean disease-free progression time was 1.28 months in the ≥ 5 CTCs group vs 31.6 months in the < 5 CTCs group (P = 0.002), and mean OS was 10.0 months vs 34.9 months (P = 0.001), respectively. A meta-analysis by Yang et al[29] including 579 patients with gastric cancer showed that CTCs-positive patients had significantly shorter PFS and OS than CTCs-negative patients (P < 0.05). Additionally, a meta-analysis of 2566 gastric cancer revealed that CTCs-positive patients had significantly poorer DFS and OS than their CTCs-negative counterparts[27]. Our results align with these findings, demonstrating that the CTCs-positive group had significantly shorter PFS than the CTCs-negative group (32.72 months vs 39.96 months; P < 0.05), suggesting that preoperative CTCs status may serve as a valuable indicator for assessing the risk of recurrence and metastasis in patients with gastric cancer. Although no significant difference in OS was observed between the two groups in our study (P > 0.05), this may be due to the relatively short follow-up period. Additionally, the analysis of recurrence patterns indicated that the CTCs-positive group had a higher incidence of peritoneal and distant metastases, supporting the hypothesis that CTCs may serve as a foundation for distant metastasis[30-32].
In a study by Kirwan et al[33] on the relationship between CTCs and coagulation in metastatic breast cancer, the results indicated that D-dimer and FIB levels were significantly higher in patients who were CTCs positive than in those who were CTCs negative. The study by Dirix et al[34] also reported that CTCs were significantly associated with increased D-dimer levels in patients with metastatic breast cancer. Wen et al[35] found that renal cell carcinoma patients with elevated FIB levels had a higher number of CTCs than those with normal FIB levels. In our study, CTCs positivity was significantly correlated with APTT, TT, D-dimer, and PLT (P < 0.05), but not with PT or FIB. These findings suggest that patients with abnormal coagulation parameters are more likely to have detectable CTCs, indicating that CTCs testing may be particularly relevant in patients with gastric cancer who present with coagulation disorders before surgery. Carcinoembryonic antigen, alpha-fetoprotein, and carbohydrate antigen 19-9 (CA19-9) are commonly used tumor markers for gastric cancer. However, their sensitivity remains suboptimal. Zeng et al[36] identified preoperative CTCs and elevated CA19-9 levels as independent predictors of poor survival in patients with gastric cancer. In recent years, CTCs and circulating tumor DNA (ctDNA) have attracted increasing interest in gastric cancer research. Bai et al[37] demonstrated that a combination of CTCs and ctDNA enhances the accuracy of prognostic prediction in patients with gastric cancer. These findings highlight the promise of integrating CTCs with other biomarkers to refine prognostic assessment in gastric cancer.
This study had several limitations. First, as a single-center retrospective analysis, the observed correlation between preoperative CTCs positivity and poor PFS rates requires further validation in larger prospective studies. Second, detailed information on tumor characteristics (e.g., precise size and type) and specific surgical procedures, which may represent potential confounding factors, was lacking. Third, only baseline CTCs status was analyzed; future studies should incorporate dynamic monitoring of CTCs levels to more accurately track disease progression. Finally, the lack of a significant difference in OS may be due to an insufficient follow-up time, underscoring the need for extended observation in subsequent studies.
CONCLUSION
Preoperative detection of CTCs is associated with adverse biological behaviors in gastric cancer and is valuable for predicting PFS. Based on these findings, we recommend integrating preoperative CTCs testing into the clinical management of patients to improve risk stratification and guide personalized treatment strategies. Further prospective studies are warranted to validate the utility of optimizing surveillance protocols and therapeutic decisions.
Furuke H, Arita T, Kuriu Y, Shimizu H, Kiuchi J, Yamamoto Y, Konishi H, Morimura R, Shiozaki A, Ikoma H, Kubota T, Nakanishi M, Fujiwara H, Okamoto K, Otsuji E. The survival after recurrence of colorectal cancer: a retrospective study focused on time to recurrence after curative resection.Surg Today. 2022;52:239-250.
[RCA] [PubMed] [DOI] [Full Text][Cited by in Crossref: 1][Cited by in RCA: 12][Article Influence: 2.4][Reference Citation Analysis (0)]
Ahmed MM, Greish YE.
MOFs-Based Biosensors for the Detection of Carcinoembryonic Antigen: A Concise Review. 2023 Preprints. Available from: bioRxiv: 2023070084.
[PubMed] [DOI] [Full Text]
Buscail E, Alix-Panabières C, Quincy P, Cauvin T, Chauvet A, Degrandi O, Caumont C, Verdon S, Lamrissi I, Moranvillier I, Buscail C, Marty M, Laurent C, Vendrely V, Moreau-Gaudry F, Bedel A, Dabernat S, Chiche L. High Clinical Value of Liquid Biopsy to Detect Circulating Tumor Cells and Tumor Exosomes in Pancreatic Ductal Adenocarcinoma Patients Eligible for Up-Front Surgery.Cancers (Basel). 2019;11:1656.
[RCA] [PubMed] [DOI] [Full Text] [Full Text (PDF)][Cited by in Crossref: 46][Cited by in RCA: 100][Article Influence: 14.3][Reference Citation Analysis (0)]
Yu E, Allan AL, Sanatani M, Lewis D, Warner A, Dar AR, Yaremko BP, Lowes LE, Palma DA, Raphael J, Vincent MD, Rodrigues GB, Fortin D, Inculet RI, Frechette E, Bierer J, Law J, Younus J, Malthaner RA. Circulating tumor cells detected in follow-up predict survival outcomes in tri-modality management of advanced non-metastatic esophageal cancer: a secondary analysis of the QUINTETT randomized trial.BMC Cancer. 2022;22:746.
[RCA] [PubMed] [DOI] [Full Text] [Full Text (PDF)][Cited by in RCA: 8][Reference Citation Analysis (0)]
Uenosono Y, Arigami T, Kozono T, Yanagita S, Hagihara T, Haraguchi N, Matsushita D, Hirata M, Arima H, Funasako Y, Kijima Y, Nakajo A, Okumura H, Ishigami S, Hokita S, Ueno S, Natsugoe S. Clinical significance of circulating tumor cells in peripheral blood from patients with gastric cancer.Cancer. 2013;119:3984-3991.
[RCA] [PubMed] [DOI] [Full Text][Cited by in Crossref: 70][Cited by in RCA: 72][Article Influence: 5.5][Reference Citation Analysis (0)]
Bai L, Ni B, Shen X, Zhang Y, Guan Y, Gu J, Zhang H, Aimaiti M, Wang S, Yue B, Shen Y, Liu Z, Xia X, Zhang Z. Effectiveness of circulating tumor cells and circulating tumor DNA in peritoneal lavage fluid for predicting metachronous peritoneal metastasis of gastric cancer.Transl Res. 2025;283:13-21.
[RCA] [PubMed] [DOI] [Full Text][Cited by in RCA: 1][Reference Citation Analysis (0)]
Footnotes
Peer review: Externally peer reviewed.
Peer-review model: Single blind
Specialty type: Oncology
Country of origin: China
Peer-review report’s classification
Scientific quality: Grade C
Novelty: Grade B
Creativity or innovation: Grade B
Scientific significance: Grade B
P-Reviewer: Hegazy AA, MD, PhD, Professor, Egypt S-Editor: Qu XL L-Editor: A P-Editor: Wang CH
