Staging Of Gastric Cancer Research Articles

Tumor-associated macrophage-derived exosome miR-194 confers cisplatin resistance in GC cells

ObjectiveAt all stages of gastric cancer (GC), cisplatin is the first-line chemotherapeutic agent, but its efficacy remains limited, with a response rate of less than 20%, largely because of resistance to the drug. It aims to determine whether macrophage-derived exosomes are involved in the mechanism of cisplatin resistance, in order to identify potential methods for reversing resistance and improving patient outcomes.MethodsMacrophages induced by IL-13 and IL-4 were characterized using flow cytometry, then co-cultured with GC cells and cisplatin. Cell viability and apoptosis were subsequently evaluated through CCK-8 assays and flow cytometry. Exosome miR-194, derived from M2 macrophages, was characterized and co-cultured with gastric cancer cells and cisplatin to assess cell survival. Furthermore, a mouse GC model was established, and miR-194 was injected to observe tumor growth.ResultsResults indicate that M2 macrophages enhance cisplatin resistance in gastric cancer cells mainly through miR-194, as demonstrated by CCK-8 and apoptosis assays. Cellular uptake experiments demonstrated that miR-194 can transfer from macrophages to GC cells and exert functional effects. Western blotting and PCR analysis further confirmed that macrophage-derived miR-194 inhibits apoptosis in GC cells and enhances cisplatin resistance by downregulating PTEN.ConclusionMacrophage-derived miR-194 promotes cisplatin resistance in GC cells by inhibiting apoptosis through PTEN downregulation. These findings provide new insights and theoretical backing for clinical treatment strategies in GC.

Predictive value of enhanced CT and pathological indicators in lymph node metastasis in patients with gastric cancer based on GEE model

ObjectivesA predictive model was developed based on enhanced computed tomography (CT), laboratory test results, and pathological indicators to achieve the convenient and effective prediction of single lymph node metastasis (LNM) in gastric cancer.MethodsSixty-six consecutive patients (235 regional lymph nodes) with pathologically confirmed gastric cancer who underwent surgery at our hospital between December 2020 and November 2021 were retrospectively reviewed. They were randomly allocated to training (n = 38, number of lymph nodes = 119) and validation (n = 28, number of lymph nodes = 116) datasets. The clinical data, laboratory test results, enhanced CT characteristics, and pathological indicators from gastroscopy-guided needle biopsies were obtained. Multivariable logistic regression with generalised estimation equations (GEEs) was used to develop a predictive model for LNM in gastric cancer. The predictive performance of the model developed using the training and validation datasets was validated using receiver operating characteristic curves.ResultsLymph node enhancement pattern, Ki67 level, and lymph node long-axis diameter were independent predictors of LNM in gastric cancer (p < 0.01). The GEE-logistic model was associated with LNM (p = 0.001). The area under the curve and accuracy of the model, with 95% confidence intervals, were 0.944 (0.890–0.998) and 0.897 (0.813–0.952), respectively, in the training dataset and 0.836 (0.751–0.921) and 0.798 (0.699–0.876), respectively, in the validation dataset.ConclusionThe predictive model constructed based on lymph node enhancement pattern, Ki67 level, and lymph node long-axis diameter exhibited good performance in predicting LNM in gastric cancer and should aid the lymph node staging of gastric cancer and clinical decision-making.

Utilization of Staging Laparoscopy for Patients With Gastric Cancer in Ukraine.

The use of advanced diagnostic methods, such as high-resolution CT or PET-CT scans, are limited in low and middle-income countries (LMICs). In gastric cancer, occult peritoneal disease may be present in up to 20% of cases, limiting the benefits of surgical resection. Accurate staging of gastric cancer is essential to ensure optimal patient management and prevent undue morbidity from unnecessary surgery. Our study evaluated the diagnostic accuracy and safety of staging laparoscopy (SL) versus computed tomography (CT) in detecting peritoneal metastases for gastric cancer in Ukraine. Patients who underwent SL between October 2017 and October 2022 were retrospectively reviewed. SL was performed for each newly diagnosed patient with gastric cancer without evidence of distant metastases, except when peritoneal carcinomatosis was in question. Pathological findings at SL were compared with initial CT reports, and analysis of the sensitivity and specificity for SL was performed. Of 516 patients undergoing SL, 410 had no radiological considerations for distant metastases. Among them, radiographically occult peritoneal metastatic disease was found in 134 (32.7%). Overall SL sensitivity for peritoneal metastases was 90.6% (95% confidence interval [CI]: 85.8%-94.1%) and specificity 100.0% (95% CI: 98.8%-100.0%). Complications after SL occurred in 5 (1%) of patients. No mortality was associated with SL. SL is a safe and effective method to evaluate the presence of peritoneal disease in patients with gastric cancer. This method may be appropriate for LMICs, where availability of advanced imaging technologies is limited.

Coagulation indices and fibrinogen degradation products as predictive biomarkers for tumor-node-metastasis staging and metastasis in gastric cancer.

Gastric cancer (GC) is a prevalent malignancy with a substantial health burden and high mortality rate, despite advances in prevention, early detection, and treatment. Compared with the global average, Asia, notably China, reports disproportionately high GC incidences. The disease often progresses asymptomatically in the early stages, leading to delayed diagnosis and compromised outcomes. Thus, it is crucial to identify early diagnostic biomarkers and enhance treatment strategies to improve patient outcomes and reduce mortality. To investigate coagulation and fibrinogen products in GC tumor-node-metastasis (TNM) stage and metastasis correlation. Retrospectively analyzed the clinical data of 148 patients with GC treated at the Civil Aviation Shanghai Hospital between December 2022 and December 2023. The associations of coagulation indices - partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT), fibrinogen, fibrinogen degradation products (FDP), fasting blood glucose, and D-dimer (D-D) with TNM stage and distant metastasis were examined. Prolongation of APTT, PT, and TT was significantly correlated with the GC TNM stage. Hence, abnormal coagulation system activation was closely related to disease progression. Elevated FDP and D-D were significantly associated with distant metastasis in GC (P < 0.05), suggesting that increased fibrinolytic activity contributes to increased metastatic risk. Our Results reveal coagulation indices, FDPs as GC biomarkers, reflecting abnormal coagulation/fibrinolysis, aiding disease progression, metastasis prediction, and helping clinicians assess thrombotic risk for early intervention and personalized treatment plans.

A Comprehensive Analysis of the Clinical Significance and Underlying Oncogenic Roles of Specific MMPs in Gastric Carcinoma Reveals their Potential Roles in Prognosis and Therapy.

Gastric cancer is a major global cause of cancer-related deaths, necessitating investigation into Matrix Metalloproteinases' (MMPs) diagnostic and prognostic value. Our study aimed to analyze their significance in gastric cancer. We evaluated MMP family genes' mRNA and protein expression using the University of Alabama at Birmingham (UALCAN) and Human Protein Atlas (HPA) databases. Then, we analyzed the relationship between their mRNA expression and gastric cancer staging and survival using Gene Expression Profiling Interactive Analysis (GEPIA) and Kaplan-Meier plotter. Furthermore, we assessed this family's gene mutation rates in gastric cancer patients using Search Tool for the Retrieval of Interaction Genes/Proteins (STRING) and explored potential pathways and mechanisms via Database for Annotation, Visualization, and Integrated Discovery (DAVID), cBioPortal, and R. Finally, we established a predictive model for gastric cancer based on these analyses to understand these genes' roles in cancer. Our findings revealed significantly upregulated mRNA expression of MMP1/2/3/7/9/10/11/12/13/14 in gastric cancer tissues (p<0.05). Higher levels of MMP2/7/10-encoded proteins (middle or high) were observed in tumor tissues, with MMP2/11/14 closely associated with different cancer stages (p<0.05). Additionally, MMP2/7/11/14/20 mRNA levels correlated with short-term overall survival (about 20 months), while MMP1/3/9/12/13 expression was associated with favorable overall survival (about 30 months). Gastric cancer patients exhibited a 21% mutation rate of MMP family genes, which correlated with favorable overall survival. Enrichment analysis and protein-protein interaction results underscored the close association of MMPs with gastric cancer development. The MMP2 model demonstrated a significant decline in survival rates for the high expression group, with a Hazard Ratio (HR) of 1.78 (95% CI 1.47-2.16) and a log-rank P value of 2.9e-09. Statistical significance was set at p < 0.05. Univariate Cox regression identified MMP2 as a risk factor for gastric cancer patients. Our findings highlighted MMPs' essential role in gastric cancer progression, impacting patient survival. MMP2 emerged as a promising target for gastric carcinoma detection and treatment.

In-Depth Examination of TPBG as a New Predictive Indicator for Gastric Cancer.

Trophoblast glycoprotein (TPBG) plays a significant part in the growth of specific cancers, yet its connection to gastric cancer (GC) remains uncertain. This research seeks to analyse the fluctuation in TPBG levels in GC and evaluate how TPBG expression relates to the prognosis of GC patients. TPBG expression in GC and normal gastric tissues was investigated in The Cancer Genome Atlas (TCGA) and Genotype-Tissue Expression (GTEx) database, further extracting the immunohistochemistry images from HPA database and validating by Western blot. The connection between TPBG and GC patients' survival rates was investigated by Kaplan-Meier and COX regression analysis. Genes related to TPBG were enriched using GO and KEGG data. Invitro and invivo tumour models were utilised to evaluate the function of TPBG in GC. Western blot analysis was performed to detect the expression of PI3K/AKT signalling pathway proteins following TPBG knockdown. Immune infiltration was analysed using the CIBERSOFT and ssGSEA methods. The association between TPBG and immune cells that infiltrate tumours was evaluated through the utilisation of GSVA. TPBG expression increased in several tumour tissues (including GC) more than in adjacent noncancerous tissues. Elevated TPBG level predicted worse outcomes, such as poorer overall survival, pathological stage, and therapy response in GC. Enrichment analysis primarily focused on biological processes like the organisation of external encapsulating structures, extracellular structure, and collagen metabolism. Biological experiments further demonstrated that TPBG knockdown successfully inhibits the progression, migration, and invasion of GC cells. Western blot analysis revealed that TPBG knockdown inhibits the PI3K/AKT signalling pathway. Furthermore, TPBG is associated with the infiltration of immune cells in GC, which correlates with the expression of macrophage cells. There is a positive relationship between TPBG and malignant behaviour of GC tissues and cells, suggesting that TPBG can be useful for diagnosing and prognosing GC.

Expression and Significance of the Circular RNA circ_0001438 in the Development of Gastric Cancer.

Gastric cancer has become a great challenge to human health in the world. We studied the expression and role of the circular RNA 0001438 (circ_0001438) with the aim of finding a biomarker to assess the prognosis of gastric cancer. Through a polymerase chain reaction, circ_0001438 expression in gastric cancer was detected. Chi-square test, multi-factor Cox regression, and Kaplan-Meier analyses were used to determine the association between circ_0001438 and the patients' clinical condition and prognosis. Using the luciferase reporter gene system, the interaction between circ_0001438 and miR-1290 was analyzed, and the regulatory impact of circ_0001438/miR-1290 on the activity of gastric cancer cells was examined flowing the Transwell assay and CCK8 assay. In gastric cancer tissues and cells, circ_0001438 expression was downregulated, and miR-1290 expression was upregulated and the two were negatively correlated. miR-1290 inhibitors were transfected and significantly increased the activity of circ_0001438 luciferase, while miR-1290 mimics decreased the activity. Overexpression of circ_0001438 decreased miR-1290 expression and inhibited the proliferation and metastasis of gastric cancer cells, which was reversed when miR-1290 mimics were transfected. Additionally, there was a correlation between circ_0001438 expression and lymph node metastases, tumor size, and TNM stage of gastric cancer. Low circ_0001438 expression predicts poor prognosis of gastric cancer patients. circ_0001438 is a biomarker for tumor development and clinical prognosis in gastric cancer. It works by downregulating miR-1290 to control the activity of gastric cancer cells.

Possibilities of indocyanine green-based visualization methods in gastric cancer surgery

Radical gastrectomy with D2 lymphadenectomy remains the primary treatment method for gastric adenocarcinoma. However, lymph node dissection in gastric cancer surgery is sometimes performed incompletely and is not accompanied by additional imaging techniques. Consequently, comprehensive lymphadenectomy is challenging. It leads to reduced volume of dissected lymph node. This study assessed the safety of gastric tumor marking and the frequency of Sentinel Lymph Node (SLN) detection through fluorescent imaging for intraoperative navigation using IndoСyanine Green (ICG) in gastric cancer. We conducted single-arm prospective observational study. The study included patients who met the inclusion criteria, underwent diagnostic laparoscopy for gastric cancer staging and received 2 to 4 cycles of neoadjuvant chemotherapy following either the FLOT (Fluorouracil, Leucovorin, Oxaliplatin and docetaxel) or FOLFOX (FluOrouracil, Leucovorin, OXaliplatin) regimen. Radical gastrectomy or distal subtotal gastric resection was performed after the neoadjuvant phase. At least one SLN was detected in 23 out of 25 patients. Among these 23 patients, the mean number of fluorescently visualized lymph nodes was 5.8±4.2 per individual patient. Among the 23 patients with identified fluorescent lymph nodes, 20 (86.9%) had at least one metastatic fluorescent lymph node, suggesting a potential tendency for contrast accumulation in metastatic lymph nodes. IGC can be safely employed for intraoperative navigation and determining the extent of lymph node dissection in gastric cancer surgery. It is safe for patients and does not induce acute or long-term adverse reactions. The use of ICG does not prolong the duration of surgical intervention and enhances intraoperative navigation through simple and accessible visualization of SLN. Keywords: sentinel lymphatic nodule, intraoperative navigation, lymphadenectomy.

Tumor Immune Microenvironment and Its Regulatory Mechanism

Gastric cancer (GC) is a highly heterogeneous tumor, and TME plays a key role in tumorigenesis and progression. TME is composed of immune cells, CAF and ECM, which regulate the growth, invasion and metastasis of GC through complex interactions. Immune escape mechanisms, such as the activation of the PD-1/PD-L1 pathway, weaken the body's anti-tumor immune response and lead to further proliferation of tumor cells. In addition, high density of immunosuppressive cells and active CAF are strongly associated with poor prognosis in patients with GC. In recent years, targeted therapeutic strategies for TME, such as immune checkpoint inhibitors (ICIs), CAF inhibitors, and ECM remodeling modulators, have shown potential therapeutic effects and become a new way to improve the survival rate of GC patients. However, due to the complexity and heterogeneity of TME, future studies still need to further explore the specific mechanism of action of TME in different stages of GC, and develop more accurate personalized treatment plans. Multidisciplinary combined treatment strategies are expected to play an important role in improving the prognosis of patients with GC.

Outstanding issues in perioperative chemotherapy for gastric cancer

Gastric cancer is an important medical and social problem all over the world. The aggressiveness of the course of this disease is reflected by the high figures of one-year mortality, which is due to both high neglect at the time of diagnosis and unsatisfactory results of surgical treatment of even a localized tumor process, which from a biological point of view casts doubt on the possibility of performing a “radical” operation for this type of malignant tumor. Currently, the “gold standard” has become the conduct of perioperative chemotherapy according to the FLOT scheme for locally advanced stages of gastric cancer, esophagogastric junction and esophagogastric junction and lower esophagus. A further promising direction for improving perioperative chemotherapy is the investigation of immune checkpoint inhibitors (pembrolizumab, atezolizumab and durvalumab) in combination with cytostatics. Today, there are still a number of unresolved issues, including the need to continue such aggressive treatment in the postoperative period with an unsatisfactory pathomorphological response from the tumor. Performing the entire volume of chemotherapy is a difficult task, due to the toxicity of this type of treatment and the weakened condition of the patient after extensive surgery. The significance of the pathomorphological regression of the tumor after neoadjuvant chemotherapy is also unclear. Only 10–15% of patients achieve a complete pathomorphological response. The standard postoperative practice is to carry out the same preoperative chemotherapy regimen, regardless of sensitivity to it. The search for prognostic markers will help to individualize the treatment strategy of such patients and protect patients from excessive toxicity with unjustified continuation of chemotherapy.

Prognostic significance of lymphovascular invasion in pN0 stage gastric cancer: a propensity score matching analysis

BackgroundTo explore the potential impact of lymphovascular invasion (LVI) on overall survival (OS) of pN0 stage gastric cancer (GC) after curative resection.MethodsA total of 497 GC patients who underwent curative gastrectomy and postoperative pathology proved negative lymph node metastasis between January 2015 and December 2018 in our center were enrolled in this study. All patients were divided into two groups according to the status of LVI. Their clinical and pathological features were compared and potential prognostic factors were analyzed using the propensity score matching analysis (PSM).ResultsNinety-nine (19.9%) patients had LVI. The presence of LVI was associated with significantly worse survival outcomes in both the overall and PSM cohorts (χ2 = 19.635, p < 0.001; χ2 = 9.367, p = 0.002). After PSM, data of 99 pairs of patients were extracted. Multivariate analysis revealed that number of examined lymph nodes (LNs), and LVI were independent predictors of OS (all p < 0.05). Following stratified analysis, patients with LNs 11–25 and those without LVI tended to have better OS than those with LVI (LNs 11–15: χ2 = 5.019, p = 0.025; LNs 16–25: χ2 = 11.876, p = 0.001).ConclusionspN0 stage GC patients with LVI have poor prognosis. More than 15 lymph nodes need to be dissected to reduce the influence of LVI on the prognosis of pN0 stage GC patients.

Diagnostic Efficacy of Staging Laparoscopy Compared to CT and PET-CT in Gastric Cancer: A Retrospective Cohort Analysis.

Background and Objectives: This study aimed to assess the diagnostic accuracy and prognostic significance of staging laparoscopy (SL) compared to computed tomography (CT) and positron emission tomography-computed tomography (PET-CT) in gastric cancer staging. We evaluated the ability of SL to detect occult peritoneal metastases and influence of SL on survival outcomes across cancer stages and treatment approaches. Materials and Methods: In this retrospective cohort study, 95 patients with gastric cancer underwent preoperative assessment using CT, PET-CT, and SL between 2018 and 2024. Diagnostic performance metrics were calculated for SL, CT, and PET/CT across the local, locally advanced, and metastatic stages. Survival outcomes were analyzed using Kaplan-Meier curves, and comparisons were made using log-rank tests. A multivariable Cox proportional hazards model incorporating interaction terms was used to determine the independent prognostic factors affecting survival, focusing on SL findings and cytology results. Results: The cohort comprised 75 males (78.9%) and 20 females (21.1%), with a mean age of 57.4 ± 10.1 years. The tumor location distribution was predominant in the corpus (31.1%) and cardia. Tumor staging revealed that 48.1% were classified as T3 and 28.8% as T4, respectively. Diagnostic accuracy analysis showed that SL outperformed CT and PET-CT in detecting peritoneal metastasis across all stages. Specifically, SL demonstrated a sensitivity and specificity of 85% and 95% for local disease, 92% and 80% for locally advanced disease, and 95% and 99% for metastatic disease, significantly exceeding those of CT and PET-CT. Patients with SL findings had a median overall survival (OS) of 30 months compared with 20 months for those assessed only with CT and PET-CT (p < 0.05). The stage-specific median OS for SL patients was 40 months in the local, 25 months in the locally advanced (p < 0.05), and 15 months in the metastatic disease (p < 0.01) groups, indicating significant survival benefits. Multivariable Cox regression identified SL findings as an independent factor associated with reduced mortality risk (HR: 0.70, 95% CI: 0.50-0.90, p < 0.01), while positive cytology findings predicted poorer survival (HR: 1.80, 95% CI: 1.25-2.60, p < 0.01). Interaction terms revealed that SL yielded greater survival benefits in patients with metastatic disease (hazard ratio [HR]: 0.60, p < 0.01) and those undergoing systemic therapy (HR: 0.75, p = 0.04). Conclusions: SL provides superior diagnostic accuracy and prognostic information for advanced gastric cancer staging compared with CT and PET-CT. By accurately detecting peritoneal metastasis, SL aids in optimizing treatment plans, particularly in advanced stages, thus potentially improving patient outcomes.

Gastric and Esophageal Cancer in Pregnancy: A Review.

Upper gastrointestinal cancers such as gastric and esophageal cancers are rare malignancies with poor prognosis because it is usually diagnosed in latter stages. Presenting symptoms are frequently presumed pregnancy related rather than malignancy related. This review will raise awareness to consider these aggressive cancers in evaluating gastrointestinal complaints during pregnancy. This review describes pregnancies with gastric and esophageal cancers including presenting symptoms, diagnosis stage, treatments, pregnancy complications, and maternal/fetal outcomes. Electronic databases (PubMed/EMBASE) were searched with English language limitation. Search terms, 1970-2023, included "stomach cancer" OR "gastric cancer" AND "etiology" OR "risk factors" OR "diagnosis" OR "treatment" OR "management" OR "prognosis" AND "pregnancy" OR "pregnancy complications" OR "Esophageal Neoplasms" OR "esophageal carcinoma" OR "esophageal malignancy" OR "esophageal cancer" OR "esophageal neoplasm" AND Pregnancy OR "Pregnancy." Of 611 abstracts reviewed, 63 full articles were identified as the basis of review. Gastric cancer stage was advanced stage III or IV in 88% of patients. Maternal mortality rate was 76%. First-trimester diagnosis occurred in 16%; second, 27%; and third, 18% totaling 61%. Thirty nine percent were found postpartum, postmortem, or undetermined. Ethnic groups most affected were East Asian. Half had cesarean delivery, 29% delivered vaginally, and the rest were not reported. Treatment varied: supportive care only, 8%; chemotherapy only, 34%; and chemotherapy and surgery, 21%. Neonatal outcomes were good overall: 90% survival among cases reported. Gastric and esophageal cancers are rare and frequently asymptomatic in early stages. When diagnosed in pregnancy, it is usually advanced with poor prognosis and high maternal mortality rate. Diagnostic testing and treatment should proceed as needed during pregnancy with close maternal and fetal surveillance. Abdominal delivery is reserved for usual obstetrical indications. Gastric and esophageal cancers are rare conditions often missed or found late that affect management, mode of delivery, and maternal/fetal outcomes.

Prognostic Value and Therapeutic Significance of CCL Chemokines in Gastric Cancer.

Gastric cancer is one of the most common malignant tumours of the gastrointestinal tract, which has a significant negative impact on human health. CCL chemokines play important roles in a variety of tumor microenvironments; nevertheless, gastric cancer has surprisingly limited associations with CCL chemokines. In our study, we comprehensively utilized bioinformatics analysis tools and databases such as cBioPortal, UALCAN, GEPIA, GeneMANIA, STRING, and TRRUST to clarify the clinical significance and biology function of CCL chemokines in gastric cancer. The mRNA expression levels of CCL1/3/4/5/7/8/14/15/18/20/21/22/26 were up-regulated, while the mRNA expression levels of CCL2/11/13/16/17/19/23/24/25/28 were down-regulated. The chemokine significantly associated with the pathological stage of gastric cancer is CCL2/11/19/21. In gastric cancer, the expression level of CCL chemokines was not associated with disease-free survival, but low expression of CCL14 was significantly associated with longer overall survival. Therein, associated with the regulation of CCL chemokines are only 10 transcription factors (RELA, NFKB1, STAT6, IRF3, REL, SPI1, STAT1, STAT3, JUN and SP1). The major biological process and functional enrichment of CCL chemokines are to induce cell-directed migration. These results may indicate that CCL chemokines may be immunotherapeutic targets and promising prognostic biomarkers for gastric cancer.

The advancement stage of gastric cancer and the levels of CEA and Ca19-9 in serum and peritoneal lavage

The advancement stage of gastric cancer and the levels of CEA and Ca19-9 in serum and peritoneal lavage

The Effect of Systemic Immune-Inflammatory Index (SII) and Prognostic Nutritional Index (PNI) in Early Gastric Cancer.

In recent years, the systemic immune-inflammatory index (SII) and prognostic nutritional index (PNI) have been considered potential predictors of survival outcomes in various solid tumors, including gastric cancer. However, there is a notable lack of research focusing on their prognostic implications specifically in the early stage of gastric cancer. This study aims to investigate the prognostic indicators of early gastric cancer (EGC), including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), SII, PNI, and lymph node metastasis (LNM). In this retrospective analysis, we examined 490 patients diagnosed with EGC (pT1Nx). The peripheral blood indices of interest were SII, PNI, PLR, and NLR. The receiver operating characteristic (ROC) curves and the area under the ROC curve (AUC) were used to determine optimal cutoff values and prognostic efficacy for each parameter. Additionally, Kaplan-Meier survival curves and multivariate Cox regression models were utilized to delineate independent prognostic factors. The optimal cutoff values for SII and PNI were determined as 613.05 and 42.21, respectively. Patients in the low SII (SII-L) group demonstrated significantly higher 5-year Disease-Free Survival (DFS) and Overall Survival (OS) rates of 94.7% and 96.2%, compared to the high SII (SII-H) group (DFS: 78.7%; OS: 81.9%), with both differences proving statistically significant (P < 0.001, P < 0.001). Similarly, patients in the high PNI (PNI-H) group showed superior 5-year DFS (93.3%) and OS rates (95.1%) versus the low PNI (PNI-L) group (DFS: 71.4%; OS: 74.3%), also demonstrating statistical significance (P < 0.001, P < 0.001). Multivariate analysis identified SII, PNI, and LNM as independent prognostic factors for EGC. A combined analysis of SII, PNI, and LNM yielded a C-index of 0.723 (P = 0.008). SII, PNI, and LNM are effective markers for predicting the survival outcomes of patients undergoing radical gastrectomy for EGC.

New Classification of Tumor Microvessels and the Risk of Regional Metastasis in Squamous Cell and Glandular Cancers

Previously, we proposed a new classification of tumor microvessels (MVs) on the basis of their morphological features and clinical significance. The aim of this study was to summarize the obtained results and establish the predictive value of different types of tumor MVs for assessing the risk of metastasis to regional lymph nodes (RLNs) in glandular and squamous cell carcinomas.&amp;lt;i&amp;gt; Materials and methods.&amp;lt;/i&amp;gt; A total of 385 archival samples of gastric cancer stages I--III, breast cancer stages I--IIIA, cervical squamous cell carcinoma stages I--IIA, and lung squamous cell carcinoma stages I--IIIA were studied. The tumor sections were processed routinely and subjected to immunohistochemistry with antibodies against cluster of differentiation 34 (CD34) and podoplanin. To assess independent predictors of the risk of metastasis to RLNs, correlation analysis and univariate and multivariate logistic regression analyses were performed. Statistical analysis was performed via Statistica 10.0 software. &amp;lt;i&amp;gt;Results.&amp;lt;/i&amp;gt; For patients with gastric cancer and breast cancer, the independent predictors of a high risk of metastasis to RLNs are T2 (p=0.007) and T3 (p&amp;lt;0.00001) stages, tumor grade 3 (p=0.0002), the presence of lymphovascular invasion (LVI) (p=0.044) and peritumoral retraction clefts (p=0.008). For patients with squamous cell carcinoma of the cervix and lung, independent predictors of a high risk of metastasis to RLNs are the T2 (p=0.01) and T3 (p=0.007) stages, the presence of LVI (p=0.0014), dilated capillaries (DCs) of the &amp;quot;contact type&amp;quot; (p=0.0007), capillaries in the tumor solid component (p=0.046) and peritumoral retraction cleftings (p=0.0006). &amp;lt;i&amp;gt;Conclusion&amp;lt;/i&amp;gt;. The results of the present study indicate that when assessing the risk of metastasis to RLNs, it is advisable to consider the presence of peritumoral retraction clefting and LVI in both glandular and squamous cell carcinomas. In addition, in squamous cell carcinomas, the accuracy of assessing the risk of metastasis to RLNs can be increased by taking into account &amp;quot;contact-type&amp;quot; DCs and capillaries in the solid component of the tumor.

Evaluating the diagnostic performance of [18F]ALF-NOTA-FAPI-04 PET/CT in gastric cancer: a comparative study with [18F]FDG PET/CT.

To compare the diagnostic value of [18F]ALF-NOTA-FAPI-04 positron emission tomography/computed tomography (PET/CT) and 18F-fluorodeoxyglucose (FDG) PET/CT in gastric cancer. This single-center retrospective analysis included 65 patients with gastric cancer who received both [18F]FDG and [18F]ALF-NOTA-FAPI-04 PET/CT for initial staging or restaging. Histopathological manifestations, typical imaging manifestations, follow-up imaging, and comprehensive clinical assessment were used as reference criteria. The uptakes of [18F]FDG and [18F]ALF-NOTA-FAPI-04 PET were compared using the Wilcoxon signed-rank test. McNemar's test was employed to compare the diagnostic performance of the two imaging techniques. A total of 65 patients were included (26 male and 39 female; mean age, 54.03 ± 10.41 years), Among them, 10 were newly diagnosed, 46 underwent radical gastrectomy, and 9 received only chemotherapy prior to the study. Compared with [18F]FDG PET/CT, [18F]ALF-NOTA-FAPI-04 PET/CT showed higher sensitivity in primary or recurrent tumors (100% vs. 64.52%, p < 0.001)), lymph node metastases (88.89% vs. 38.89%, p = 0.006), distant metastases (91.18% vs. 50%, p < 0.001). From the semi-quantitative evaluation, the Maximum standardized uptake value (SUVmax) and target-to-background ratio of [18F]ALF-NOTA-FAPI-04 PET/CT were significantly higher than that of [18F]FDG PET/CT in primary or recurrent tumors, lymph node metastases, and distant metastases (all p < 0.001). Our study results indicate that [18F]ALF-NOTA-FAPI-04 PET/CT outperforms [18F]FDG PET/CT in the detection of primary or recurrent tumors, lymph node metastasis, and distant metastasis in gastric cancer. Question Early diagnosis and precise staging of gastric cancer are crucial for patient prognosis; however, current imaging techniques still face significant limitations. Findings [18F]ALF-NOTA-FAPI-04 PET/CT demonstrated significantly higher sensitivity than [18F]FDG PET/CT in detecting primary or recurrent tumors and metastases in patients with gastric cancer. Clinical relevance [18F]ALF-NOTA-FAPI-04 PET/CT is an advanced imaging diagnostic technique that significantly enhances the diagnostic accuracy for gastric cancer and its metastatic lesions. This technology provides robust support for clinical decision-making, thereby improving the management of patients with gastric cancer.

ILF2 protein is a promising serum biomarker for early detection of gastric cancer

BackgroundOur previous small-sample study indicated that serum levels of interleukin enhancer binding factor 2 (ILF2) may have the potential for gastric cancer (GC) detection. The present study was conducted to further validate the diagnostic value of serum ILF2 protein for GC.MethodsSerum specimens and clinical data were collected from patients with GC (n = 99) or benign gastric disease (BGD) (n = 49) and healthy controls (HC) (n = 51). Serum ILF2 levels were measured using enzyme-linked immunosorbent assay. The diagnostic performance of ILF2 was evaluated using the area under the receiver operating characteristic curve (AUC). The independence and synergy of ILF2 in GC diagnosis were analyzed by modeling with conventional blood indicators.ResultsThe median serum ILF2 level was higher in the GC group (227.8ng/mL) than in the BGD group (72.0ng/mL) and the HC group (56.8ng/mL) (p < 0.001), and no significant difference across GC subgroups. The AUCs of ILF2 were 0.915 (95%CI 0.873–0.957) for GC vs. HC, 0.854 (95%CI 0.793–0.915) for GC vs. BGD, 0.885 (95%CI 0.841–0.929) for GC vs. BGD + HC, and 0.888 (95% CI 0.830–0.945) for TNM I stage GC vs. BGD + HC, outperforming conventional blood indicators (corresponding AUCs ranging from 0.641 to 0.782). ILF2 was independent of and synergistic with conventional blood indicators in GC diagnosis, and a simple diagnostic model based on ILF2 and red blood cell count improved the diagnostic performance, with positive rates of approximately 90% in various subgroups of GC.ConclusionsSerum ILF2 protein is a novel and potential serum biomarker for the detection of GC, especially for early GC.

SLITRK2 as a prognostic and immunological biomarker in gastric cancer

BackgroundSLIT and NTRK-like protein 2 (SLITRK2) encodes a transmembrane protein that regulates neurite outgrowth. Some studies have demonstrated that SLITRK2 overexpressed in glioma. But the expression pattern, prognostic value and immunologic function of SLITRK2 in tumors remains unknown.MethodsThe expression pattern of SLITRK2 among pan-cancers was examined through the Cancer Genome Atlas (TCGA) and Genotype-Tissue Expression (GTEx). We analyzed the association between SLITRK2 expression level and tumor stage among pan-cancers. Kaplan–Meier survival analysis was utilized to investigate the prognostic relevance of SLITRK2 across 33 different types of cancers. Moreover, the correlations among SLITRK2 expression, immune cell infiltration, immunomodulatory related genes, tumor mutation burden (TMB), microsatellite instability (MSI) were evaluated. The relationship between SLITRK2 expression and crucial genes mutations was also illustrated. By using tissue microarray (TMA), the expression of SLITRK2 in 89 paired gastric cancer (GC) tissues was investigated.ResultsOur study indicated that SLITRK2 expression varied across cancers. Elevated SLITRK2 expression was positively related to advanced tumor stage, poor overall survival (OS) and reduced disease-free survival (DFS). Bioinformatic analyses underscore SLITRK2’s role in immune response, with its expression significantly tied to immune cell infiltration and marker expression. Based on TMA data, SLITRK2 expression level was positively associated with differentiation, lymph node metastasis, AJCC stage, TNM stage, and poor survival outcome in GC patients.ConclusionOur findings provided that SLITRK2 may function as a biomarker by regulating immune cell infiltration. In addition, we verified that high SLITRK2 expression was correlated with poor prognosis in GC.