Abstract: Objective To systematically evaluate the role of the low expression level of circRNA in the diagnosis and
prognosis of gastric cancer. Methods The English databases including PubMed, EMbase and Web of Science were
systematically searched with the search time from the establishment of the database to June 2019. All eligible studies
associated with circRNA and prognosis or diagnosis in gastric cancer were included. Three researchers independently
screened the included studies, extracted data and evaluated the quality. The Stata 14.0 software was used for Meta-analysis.
Results A total of 20 relevant studies were eligible, including 9 on prognosis and 16 on diagnosis. As for
clinicopathological parameters, the low expression of antineoplastic circRNAs showed a significant association with poor
clinicopathological features. For the prognostic values, high-regulated antineoplastic circRNAs showed the favorable impact
on overall survival (HR=0.37, 95% CI: 0.29-0.48). The results revealed a sensitivity of 0.73 (95%CI: 0.66-0.79), a
specificity of 0.77 (95% CI：0.68-0.84), and an AUC of 0.81(95% CI: 0.77-0.84) for gastric cancer diagnosis with circRNAs.
Conclusion The low expression of circRNA has certain value in the prognosis and diagnosis of gastric cancer, but it still
needs more high-quality clinical research to further confirm.

Key words: stomach neoplasms, diagnosis, prognosis, circRNA, Meta-analysis