PT - JOURNAL ARTICLE AU - Bochao Zhao AU - Wu Lv AU - Di Mei AU - Rui Luo AU - Shiyang Bao AU - Baojun Huang AU - Jie Lin TI - Perineural invasion as a predictive factor for survival outcome in gastric cancer patients: a systematic review and meta-analysis AID - 10.1136/jclinpath-2019-206372 DP - 2020 Sep 01 TA - Journal of Clinical Pathology PG - 544--551 VI - 73 IP - 9 4099 - http://jcp.bmj.com/content/73/9/544.short 4100 - http://jcp.bmj.com/content/73/9/544.full SO - J Clin Pathol2020 Sep 01; 73 AB - Aims The prognostic significance of perineural invasion (PNI) for gastric cancer (GC) patients was under debate. This study aimed to review relevant studies and evaluate the impact of PNI on the survival outcome of GC patients.Methods Systematic literature search was performed using PubMed and Embase databases. The relevant data were extracted, and the association between PNI and clinicopathological characteristics or survival outcome in GC patients were evaluated using a fixed-effect model or random-effect model.Results A total 13 studies involving 7004 GC patients were included in this meta-analysis. The positive rate of PNI was 35.9% (2512/7004) in GC patients, ranging from 6.9% to 75.6%. There were significant relationships between PNI and a series of unfavourable clinicopathological factors including undifferentiated histology type (OR: 1.78, 95% CI 1.37 to 2.33, p<0.001; I2=75.3%), diffuse type (OR: 1.96, 95% CI 1.07 to 3.60, p=0.029; I2=79.5%), lymphatic invasion (OR: 7.00, 95% CI 3.76 to 13.03, p<0.001; I2=83.6%), vascular invasion (OR: 5.79, 95% CI 1.59 to 21.13, p=0.008; I2=95.8%), deeper tumour invasion (OR: 4.79, 95% CI 3.65 to 6.28, p<0.001; I2=65.0%) and lymph node metastasis (OR: 3.60, 95% CI 2.37 to 5.47, p<0.001; I2=89.6%). In addition, PNI was significantly associated with worse survival outcome in GC patients (HR: 1.69, 95% CI 1.38 to 2.06, p<0.001; I2=71.0%).Conclusion PNI was frequently detected in surgically resected specimens of GC patients, and it was a predictive factor for survival outcomes in these patients.