Gastric cancer (GC) is the fifth most common cancer and the third leading cause of cancer-related deaths in China. Many patients with GC frequently experience symptoms related to the disease, including anorexia, nausea, vomiting, and other discomforts, and often suffer from malnutrition, which in turn negatively affects perioperative safety, prognosis, and the effectiveness of adjuvant therapeutic measures. Consequently, some nutritional indicators such as nutritional risk index (NRI), prognostic nutritional index (PNI), and systemic immune-inflammatory-nutritional index (SIINI) can be used as predictors of the prognosis of GC patients.

To examine the prognostic significance of PNI, NRI, and SIINI in postoperative patients with GC.

A retrospective analysis was conducted on the clinical data of patients with GC who underwent surgical treatment at the Guangxi Medical University Cancer Hospital between January 2010 and December 2018. The area under the receiver operating characteristic (ROC) curve was assessed using ROC curve analysis, and the optimal cutoff values for NRI, PNI, and SIINI were identified using the You-Review-HTMLden index. Survival analysis was performed using the Kaplan-Meier method. In addition, univariate and multivariate analyses were conducted using the Cox proportional hazards regression model.

This study included a total of 803 patients. ROC curves were used to evaluate the prognostic ability of NRI, PNI, and SIINI. The results revealed that SIINI had superior predictive accuracy. Survival analysis indicated that patients with GC in the low SIINI group had a significantly better survival rate than those in the high SIINI group (P < 0.05). Univariate analysis identified NRI [hazard ratio (HR) = 0.68, 95% confidence interval (CI): 0.52-0.89, P = 0.05], PNI (HR = 0.60, 95%CI: 0.46-0.79, P < 0.001), and SIINI (HR = 2.10, 95%CI: 1.64-2.69, P < 0.001) as prognostic risk factors for patients with GC. However, multifactorial analysis indicated that SIINI was an independent risk factor for the prognosis of patients with GC (HR = 1.65, 95%CI: 1.26-2.16, P < 0.001).

Analysis of clinical retrospective data revealed that SIINI is a valuable indicator for predicting the prognosis of patients with GC. Compared with NRI and PNI, SIINI may offer greater application for prognostic assessment.

• Systemic immune-inflammatory-nutritional index
• Prognostic nutritional index
• Nutritional risk index
• Gastric cancer
• Prognosis

• CKAP2
• aging
• gastric cancer

• Humans
• Stomach Neoplasms/genetics
• Stomach Neoplasms/metabolism
• Stomach Neoplasms/pathology
• Gene Expression Regulation, Neoplastic
• Biomarkers, Tumor/metabolism
• Biomarkers, Tumor/genetics
• Prognosis
• Disease Progression
• Computational Biology/methods
• Cytoskeletal Proteins/metabolism
• Cytoskeletal Proteins/genetics
• Multiomics

• Driver genes
• Gastric cancer
• Mutational signatures
• Somatic alterations
• Tumor molecular heterogeneity

• Adult
• Aged
• Aged, 80 and over
• Female
• Humans
• Male
• Middle Aged
• Biomarkers, Tumor/genetics
• China/epidemiology
• DNA Mutational Analysis
• East Asian People/genetics
• Exome Sequencing
• Mutation
• Stomach Neoplasms/genetics

• National Cancer Institute (NCI)

• Challenges
• Epidemiology
• Gastric cancer
• Opportunities
• Risk factors
• Targeted therapies
• Treatment strategies

• Humans
• Stomach Neoplasms/therapy
• Stomach Neoplasms/epidemiology
• Stomach Neoplasms/genetics
• Risk Factors
• Helicobacter Infections/complications
• Helicobacter Infections/epidemiology

• Laparoscopic
• Long-term outcomes
• Neoadjuvant chemotherapy
• Open
• Total gastrectomy

• Humans
• Stomach Neoplasms/surgery
• Stomach Neoplasms/mortality
• Stomach Neoplasms/pathology
• Stomach Neoplasms/drug therapy
• Gastrectomy/methods
• Male
• Female
• Laparoscopy/methods
• Middle Aged
• Neoadjuvant Therapy/methods
• Retrospective Studies
• Aged
• Treatment Outcome
• Adult
• Propensity Score
• Kaplan-Meier Estimate
• Disease-Free Survival
• Follow-Up Studies

• Alcohol consumption
• Community survey
• Gastric cancer
• Physical activity
• Smoking

• Humans
• Male
• Female
• Stomach Neoplasms/epidemiology
• Middle Aged
• Life Style
• Alcohol Abstinence
• Resistance Training
• Aged
• Republic of Korea/epidemiology
• Adult
• Alcohol Drinking/epidemiology
• Patient Education as Topic
• Nutrition Surveys
• Health Behavior

• KGCA042022B1 Korean Gastric Cancer Association
• KGCA2022IC5 Korean Gastric Cancer Association

• biophysics
• cancer
• drug discovery
• systems biology

• Stomach Neoplasms/drug therapy
• Stomach Neoplasms/pathology
• Stomach Neoplasms/metabolism
• Humans
• Drug Resistance, Neoplasm
• Models, Biological
• Molecular Targeted Therapy/methods
• Cluster Analysis
• Principal Component Analysis
• Vascular Endothelial Growth Factor A/metabolism
• Vascular Endothelial Growth Factor A/antagonists & inhibitors
• Signal Transduction/drug effects

• 国家自然科学基金委员会

• gastric cancer
• meta-analysis
• mortality
• overall survival
• recurrence free survival
• systematic review
• systemic immune inflammation index

• Gastric cancer
• Immune
• Prognostic signature
• Subtypes
• T cell-mediated tumor killing
• qRT-PCR

• Humans
• Stomach Neoplasms/genetics
• Stomach Neoplasms/therapy
• Prognosis
• T-Lymphocytes
• Cluster Analysis
• RNA-Seq

• LH2020H114 Heilongjiang Provincial Natural Science Foundation of China

• Clec11a
• gastric cancer
• immunotherapy
• prognosis
• tumor microenvironment

• Animals
• Humans
• Mice
• Biological Assay
• Cell Differentiation
• Cell Division
• Cell Movement
• Stomach Neoplasms/genetics
• Tumor Microenvironment/genetics

• Biomarker
• Gastric carcinoma
• MRG
• Prognosis
• Single-cell RNA sequencing
• Transcriptomics

• Humans
• RNA
• Mitophagy/genetics
• Prognosis
• Stomach Neoplasms/genetics
• Sequence Analysis, RNA
• Carcinoma

• SEER
• bone metastases
• gastric cancer
• nomogram
• risk factors

• Humans
• Bone Neoplasms/diagnosis
• Internet
• Nomograms
• Prognosis
• Retrospective Studies
• Stomach Neoplasms/diagnosis
• Adolescent
• Young Adult
• Adult
• Middle Aged
• Aged
• Aged, 80 and over

• gastric cancer
• metabolism
• molecular subtypes
• multi-omics
• prognosis

• MXD3
• chromatin regulators
• molecular subtypes
• prognostic model
• prostate cancer

• Multidetector Computed Tomography
• Neoplasm Invasiveness
• Pancreas
• Stomach Neoplasms
• Task Performance and Analysis

• National Research Foundation of Korea
• Seoul National University Hospital

• Zhejiang Province Public Welfare Technology Application Research Project

Hemoglobin and albumin are associated with the prognosis of gastric cancer (GC) patients. However, the prognostic value of the hemoglobin to albumin ratio (HAR) for the short-term survival of GC patients with D2 radical resection has not been studied.

To investigate the significance of the HAR in evaluating the short-term survival of GC patients after D2 radical resection and to construct a nomogram to predict the prognosis in GC patients after surgery, thus providing a reference for the development of postoperative individualized treatment and follow-up plans.

Cox regression and Kaplan-Meier analysis was used for prognostic analysis. Logistic regression was used to analyze the relationships between HAR and the clinicopathological characteristics of the GC patients. A prognostic nomogram model for the short-term survival of GC patients was constructed by R software.

HAR was an independent risk factor for the short-term survival of GC patients. GC patients with a low HAR had a poor prognosis (P < 0.001). Low HAR was markedly related to high stage [odds ratio (OR) = 0.45 for II vs I; OR = 0.48 for III vs I], T classification (OR = 0.52 for T4 vs T1) and large tumor size (OR = 0.51 for ≥ 4 cm vs < 4 cm) (all P < 0.05). The nomogram model was based on HAR, age, CA19-9, CA125 and stage, and the C-index was 0.820.

Preoperative low HAR was associated with short-term survival in GC patients. The prognostic nomogram model can accurately predict the short-term survival of GC patients with D2 radical resection.

• Gastric cancer
• Hemoglobin to albumin ratio
• Short-term survival
• Prognosis
• Nomogram

The recent approvals for antibody-drug conjugates (ADCs) in multiple malignancies in recent years have fuelled the ongoing development of this class of drugs. These novel agents combine the benefits of high specific targeting of oncogenic cell surface antigens with the additional cell kill from high potency cytotoxic payloads, thus achieving wider therapeutic windows. This review will summarise the clinical activity of ADCs in tumour types not covered elsewhere in this issue, such as gastrointestinal (GI) and genitourinary (GU) cancers and glioblastoma (GBM). In addition to the ongoing clinical testing of existing ADCs, there is substantial preclinical and early phase testing of newer ADCs or ADC incorporating strategies. This review will provide selected insights into such future development, focusing on the development of novel ADCs against new antigen targets in the tumour microenvironment (TME) and combination of ADCs with immuno-oncology (IO) agents.

Noncoding ribonucleic acids (ncRNAs) are involved in various functions in the formation and progression of different tumors. However, the association between N6-methyladenosine-related ncRNAs (m6A-related ncRNAs) and gastric cancer (GC) prognosis remains elusive. As such, this research was aimed at identifying m6A-related ncRNAs (lncRNAs and miRNAs) in GC and developing prognostic models of relevant m6A-related ncRNAs and identifying potential biomarkers regulated by m6A. In this study, the m6A2Target database, Starbase database, and The Cancer Genome Atlas (TCGA) were used to screen m6A-related ncRNAs. And then, we performed integrated bioinformatics analyses to determine prognosis-associated ncRNAs and to develop the m6A-related ncRNA prognostic signature (m6A-NPS) for GC patients. Finally, five m6A-related ncRNAs (including lnc-ARHGAP12, lnc-HYPM-1, lnc-WDR7-11, LINC02266, and lnc-PRIM2-7) were identified to establish m6A-NPS. The predictive power of m6A-NPS was better in the receiver operating characteristic (ROC) curve analysis of the training set (area under the curve (AUC), >0.6). The m6A-NPS could be utilized to classify patients into high- and low-risk cohorts, and the Kaplan-Meier analysis indicated that participants in the high-risk cohort had a poorer prognosis. The entire TCGA dataset substantiated the predictive value of m6A-NPS. Significant differences in TCGA molecular GC subtypes were observed between high- and low-risk cohorts. The ROC curve analysis indicated that m6A-NPS had better predictive power than other clinical characteristics of GC prognosis. Uni- and multivariate regression analyses indicated m6A-NPS as an independent prognostic factor. Furthermore, the m6A status between the low-risk cohort and high-risk cohort was significantly different. Differential genes between them were enriched in multiple tumor-associated signaling pathways. In summary, five m6A-related ncRNA signatures that could forecast the overall survival of patients with GC were identified.

Long noncoding RNAs (lncRNAs) have diverse functions, including immune regulation. Increasing studies have reported immune-related lncRNAs in the prognosis of multiple cancers. In this study, we developed an individualized signature containing 13 immune-related lncRNA pairs (IRLPs) which could predict the overall survival, disease-free survival, progression-free survival, and disease-specific survival of gastric cancer (GC) patients in The Cancer Genome Atlas (TCGA) cohort, and internal and external validations, signature comparisons, and subgroup analyses further confirmed its superiority, stability, and generalizability. Notably, this signature also showed good applicability in discriminating the prognosis of pan-cancer patients. Then, we constructed and validated a nomogram for overall survival based on the signature and clinical factors, which allowed more accurate predictions of GC prognosis. In addition, we revealed that the low survival rate of patients with high-risk scores may be due to their aggressive clinical features, enriched cancer-related signaling pathways, the infiltration of specific immunosuppressive cells, and low tumor mutation burden. We further predicted obviously worse immunotherapeutic responses in the high-risk groups and identified some candidate compounds targeting GC risk group differentiation. This signature based on the IRLPs may be promising for predicting the survival outcomes and immunotherapeutic responses of GC patients in clinical practice.

• gastric cancer
• immune
• immunotherapy
• long noncoding RNA
• prognostic signature

Asians have the highest incidence of gastric cancer (GC), and the prognosis of Asian GC is poor. Furthermore, the therapeutics for Asian GC is limited because of genetic heterogeneity and screening difficulty at the early stage. This study aimed to develop an immune-related gene (IRG)-based prognostic signature and to explore prognosis-related regulatory mechanism and therapeutic target for Asian GC.

To elucidate the prognostic value of IRGs in Asian GC, a comprehensive analysis of IRG expression profiles and overall survival times in 364 Asian GC patients from the Asian Cancer Research Group (ACRG) and The Cancer Genome Atlas (TCGA) databases was performed, and a novel prognostic index was established. To further explore regulatory prognosis mechanisms and therapeutic targets, a tumor immunogenomic landscape analysis, including stromal and immune subcomponents, cell types, panimmune gene sets, and immunomodulatory genes, was performed.

Our analysis allowed the creation of an optimal risk assessment model, the Asian-specific IRG-based prognostic index (ASIRGPI), which showed a high accuracy in predicting survival in Asian GC. We also developed an ASIRGPI-based nomogram to predict the 3- and 5-year overall survival (OS) of Asian GC patients. The impact of the ASIRGPI on the worse prognosis of Asian GC was possibly related to the stromal component remodeling. Specifically, TGFβ gene sets were significantly associated with the ASIRGPI and worse prognosis. Immunomodulatory gene analysis further revealed that TGFβ1 and EDNRB may be the novel potential therapeutic targets for Asian GC.

As a tumor microenvironment-relevant gene set-based prognostic signature, the ASIRGPI model provides an effective approach for evaluating the prognosis of Asian GC and may even prolong OS by enabling the selection of individualized therapy with the novel targets.

• Asian cancer
• gastric cancer
• immunomodulatory gene
• immunotherapy
• prognostic gene signature

• Gastric cancer (GC)
• Gli1
• Human telomerase reverse transcriptase (hTERT)
• Invasion
• Metastasis
• Sp1

Accepting the crucial role of the immune microenvironment (TME) in tumor progression enables us to identify immunotherapeutic targets and develop new therapies. Glycoprotein A repetitions predominant (GARP) plays a vital part in maintaining regulatory T cell (Treg)-mediated immune tolerance. The impact of GARP in TME of gastric cancer is still worth exploring. We investigated public genomic datasets from The Cancer Genome Atlas and Gene Expression Omnibus to analyze the possible role of GARP and its relationship with TME of gastric cancer. Fluorescence-based multiplex immunohistochemistry and immunohistochemistry for T-cell immune signatures in a series of tissue microarrays were used to validate the value of GARP in the TME. We initially found that GARP expression was upregulated in gastric carcinoma cells, and diverse levels o3f immune cell infiltration and immune checkpoint expression were detected. Gene expression profiling revealed that GARP expression was related to the TME of gastric cancer. GARP upregulation was usually accompanied by increased FOXP3+ Treg and CD4+ T cell infiltration. In addition, GARP expression had positive relationships with CTLA-4 and PD-L1 expression in gastric cancer. Cox regression analysis and a nomogram highlighted that the probability of poor overall survival was predicted well by GARP or GARP+CD4+ T cell. Taken together, this research underlines the potential effect of GARP in regulating survival and tumor-infiltrating T-cells. In addition, the function of CD4+ T cell immune signatures in the prognosis can be clinically meaningful, thereby providing a new idea for the immunotherapeutic approach.

• GARP
• TMA
• TME
• gastric cancer
• mIHC

Hypoxia is one driving factor of gastric cancer. It causes a series of immunosuppressive processes and malignant cell responses, leading to a poor prognosis. It is clinically important to identify the molecular markers related to hypoxia.

We screened the prognostic markers related to hypoxia in The Cancer Genome Atlas database, and a risk score model was developed based on these markers. The relationships between the risk score and tumor immune microenvironment were investigated. An independent validation cohort from Gene Expression Omnibus was applied to validate the results. A nomogram of risk score model and clinicopathological factor was developed to individually predict the prognosis.

We developed a hypoxia risk score model based on SERPINE1 and EFNA3. Quantified real-time PCR was further applied to verified gene expressions of SERPINE1 and EFNA3 in gastric cancer patients and cell lines. A high-risk score is associated with a poor prognosis through the immunosuppressive microenvironment and immune escape mechanisms, including infiltration of immunosuppressive cells, expression of immune checkpoint molecules, and enrichment of signal pathways related to cancer and immunosuppression. The nomogram basing on the hypoxia-related risk score model showed a good ability to predict prognosis and high clinical net benefits.

The hypoxia risk score model revealed a close relationship between hypoxia and tumor immune microenvironment. The current study potentially provides new insights of how hypoxia affects the prognosis, and may provide a new therapeutic target for patients with gastric cancer.

• gastric cancer
• hypoxia
• nomogram
• prognosis
• tumor immune microenvironment

• Borrmann classification
• clinicopathological
• gastric cancer
• gross morphology
• molecular
• prognosis

CD4⁺ memory T cells are an important component of the tumor microenvironment (TME) and affect tumor occurrence and progression. Nevertheless, there has been no systematic analysis of the effect of CD4⁺ memory T cells in gastric cancer (GC).

Three datasets obtained from microarray and the corresponding clinical data of GC patients were retrieved and downloaded from the Gene Expression Omnibus (GEO) database. We uploaded the normalize gene expression data with standard annotation to the CIBERSORT web portal for evaluating the proportion of immune cells in the GC samples. The WGCNA was performed to identify the modules the CD4⁺ memory T cell related module (CD4⁺ MTRM) which was most significantly associated with CD4⁺ memory T cell. Univariate Cox analysis was used to screen prognostic CD4⁺ memory T cell-related genes (CD4⁺ MTRGs) in CD4⁺ MTRM. LASSO analysis and multivariate Cox analysis were then performed to construct a prognostic gene signature whose effect was evaluated by Kaplan-Meier curves and receiver operating characteristic (ROC), Harrell’s concordance index (C-index), and decision curve analyses (DCA). A prognostic nomogram was finally established based on the CD4⁺ MTRGs.

We observed that a high abundance of CD4⁺ memory T cells was associated with better survival in GC patients. CD4⁺ MTRM was used to stratify GC patients into three clusters by unsupervised clustering analysis and ten CD4⁺ MTRGs were identified. Overall survival, five immune checkpoint genes and 17 types of immunocytes were observed to be significantly different among the three clusters. A ten-CD4⁺ MTRG signature was constructed to predict GC patient prognosis. The ten-CD4⁺ MTRG signature could divide GC patients into high- and low-risk groups with distinct OS rates. Multivariate Cox analysis suggested that the ten-CD4⁺ MTRG signature was an independent risk factor in GC. A nomogram incorporating this signature and clinical variables was established, and the C-index was 0.73 (95% CI: 0.697–0.763). Calibration curves and DCA presented high credibility for the OS nomogram.

We identified three molecule subtypes, ten CD4⁺ MTRGs, and generated a prognostic nomogram that reliably predicts OS in GC. These findings have implications for precise prognosis prediction and individualized targeted therapy.

• CD4+ memory T cell
• gastric cancer
• prognostic signature
• tumor microenvironment
• weighted gene co-expression network analysis

• TIICs
• gastric cancer
• immune risk score model
• multivariate cox regression
• prognosis

Gastric carcinoma (GC) is currently one of the most common malignant tumors of the digestive system, and gastric precancerous lesions play a vital role in studying the mechanism of GC. Multiple microRNAs (miRNAs) have been documented to be potential biomarkers to indicate progression of gastric precancerous lesions. In this study, we explained the anti-cancer effect of miR-365 in gastric precancerous lesions via regulation of the TLR4/IRF3/YAP/CDX2 axis.

miR-365, TLR4, CDX2 and IPF3 expression was determined in GC and atrophic gastritis tissues and cells. After transfection of shRNA and overexpression plasmids, in vitro experiments detected the alteration of cell viability, apoptosis and inflammatory factors. Bioinformatics analysis, Co-IP and dual luciferase reporter gene assay were conducted to evaluate the binding between miR-365 and TLR4 as well as IRF3 and YAP. Rat models were established to explore the effect of the miR-365 and TLR4 on gastric precancerous lesions.

miR-365 was poorly expressed in GC and atrophic gastritis tissues and GC cell lines, while TLR4, CDX2 and IRF3 were overexpressed. Of note, miR-365 was indicated to target TLR4 and thereby suppressed cancer progression and increased hemoglobin content. Interestingly, silencing of TLR4 was accompanied by decreased IRF3 phosphorylation and reduced expression with less binding between CDX2 and IRF3. Downregulation of YAP resulted in declined CDX2 expression in cancer cells. Moreover, the inhibitory role of miR-365 was further confirmed in animal models.

Taken together, miR-365-mediated TLR4 inhibition reduces IRF3 phosphorylation and YAP-mediated CDX2 transcription to impede progression of gastric precancerous lesions.

• CDX2
• Gastric precancerous lesions
• IRF3
• MicroRNA-365
• TLR4
• YAP

• gastric cancer
• machine learning
• prognostic signature
• targeted therapy
• tumor microenvironment

Increasing evidences have found that the clinical importance of the interaction between hypoxia and immune status in gastric cancer microenvironment. However, reliable prognostic signatures based on combination of hypoxia and immune status have not been well-established. This study aimed to develop a hypoxia-immune-based gene signature for risk stratification in gastric cancer.

Hypoxia and immune status was estimated with transcriptomic profiles for a discovery cohort from GEO database using the t-SNE and ESTIMATE algorithms, respectively. The Cox regression model with the LASSO method was applied to identify prognostic genes and to develop a hypoxia-immune-based gene signature. The TCGA cohort and two independent cohorts from GEO database were used for external validation.

Low hypoxia status (p < 0.001) and high immune status (p = 0.005) were identified as favorable factors for patients’ overall survival. By using the LASSO model, four genes, including CXCR6, PPP1R14A and TAGLN, were identified to construct a gene signature for risk stratification. In the discovery cohort (n = 357), patients with low risk yielded better outcomes than those with high risk regarding overall survival across and within TNM stage subgroups. Multivariate analysis identified the hypoxia-immune-based gene signature as an independent prognostic factor (p < 0.001). A nomogram integrating the gene signature and known risk factors yielded better performance and net benefits in calibration and decision curve analyses. Similar results were validated in the TCGA (n = 321) and two independent GEO (n = 300 and n = 136, respectively) cohorts.

The hypoxia-immune-based gene signature represents a promising tool for risk stratification tool in gastric cancer. It might serve as a prognostic classifier for clinical decision-making regarding individualized prognostication and treatment, and follow-up scheduling.

• Gastric cancer
• Hypoxia
• Immune
• Microenvironment
• Prediction
• Prognosis

• albumin globulin ratio
• gastrectomy
• gastric cancer
• immunity
• neutrophil monocyte lymphocyte ratio
• nutrition
• prognostic

• Aged
• Cohort Studies
• Female
• Gastrectomy
• Globulins/analysis
• Humans
• Lymphocytes/metabolism
• Male
• Monocytes/metabolism
• Neutrophils/metabolism
• Nomograms
• Prognosis
• Retrospective Studies
• Serum Albumin
• Stomach Neoplasms/mortality
• Stomach Neoplasms/pathology
• Stomach Neoplasms/surgery

• Gastric cancer
• Heparanase
• Immunotherapy
• Invasion and metastasis

• Disease Progression
• Glucuronidase/genetics
• Glucuronidase/metabolism
• Humans
• Immunotherapy
• Neoplasm Metastasis
• Neovascularization, Pathologic
• Stomach Neoplasms/enzymology
• Stomach Neoplasms/genetics
• Stomach Neoplasms/pathology
• Stomach Neoplasms/therapy

• gastrectomy
• gastric cancer
• immune cell
• inflammatory cell
• prognostic

• Epithelial‐mesenchymal transition
• Gastric cancer
• Microsatellite instability
• Molecular classification
• Prognosis

• Adult
• Aged
• Aged, 80 and over
• Algorithms
• Female
• Humans
• Male
• Middle Aged
• Prognosis
• Stomach Neoplasms/genetics

To assess the relationship between contrast-enhanced ultrasound (CEUS) parameters and perfusion CT (PCT) parameters of gastric cancers and their correlation with histologic features.

This prospective study was approved by our Institutional Review Board. We included 43 patients with pathologically-proven gastric cancers undergoing CEUS using SonoVue® (Bracco) and PCT on the same day. Correlation between the CEUS parameters (peak intensity [PI], area under the curve [AUC], rise time [RT] from 10% to 90% of PI, time to peak [TTP_US], and mean transit time [MTT_US]) and PCT parameters (blood flow, blood volume, TTP_CT, MTT_CT, and permeability surface product) of gastric cancers were analyzed using Spearman's rank correlation test. In cases of surgical resection, the CEUS and PCT parameters were compared according to histologic features using Mann-Whitney test.

CEUS studies were of diagnostic quality in 88.4% (38/43) of patients. Among the CEUS parameters of gastric cancers, RT and TTP_US showed significant positive correlations with TTP_CT (rho = 0.327 and 0.374, p = 0.045 and 0.021, respectively); PI and AUC were significantly higher in well-differentiated or moderately-differentiated tumors (n = 4) than poorly-differentiated tumors (n = 18) (p = 0.026 and 0.033, respectively), whereas MTT_CT showed significant differences according to histologic types (poorly cohesive carcinoma [PCC] vs. non-PCC), T-staging (≤ T2 vs. ≥ T3), N-staging (N0 vs. N-positive), and epidermal growth factor receptor expression (≤ faint vs. ≥ moderate staining) (p values < 0.05).

In patients with gastric cancers, CEUS is technically feasible for the quantification of tumor perfusion and may provide correlative and complementary information to that of PCT, which may allow prediction of histologic features.

• Contrast-enhanced ultrasound (CEUS)
• Histologic grade
• Perfusion imaging
• Stomach cancer

Gastric adenocarcinoma concurrent with metastatic neuroendocrine cancer (NEC) is rare. In the present case report, a 39-year-old male was first pathologically diagnosed by gastric endoscopy as having a highly differentiated adenocarcinoma. Next, positron emission tomography-computed tomography examination and bone marrow biopsy confirmed extensive metastasis. Subsequently, the patient underwent 6 cycles of immunotherapy (nivolumab, 160 mg) and 5 cycles of chemotherapy based on the XELOX regimen (oxaliplatin + capecitabine). Following this, the patient received the final cycles of nivolumab and XELOX; however, the patient then succumbed. Further biopsy of the metastatic collarbone lymph nodes indicated NEC. Overall, the progression-free survival was ~3.5 months, and overall survival (OS) was ~6 months. The case presented the possibility of concurrent gastric adenocarcinoma and NEC in the clinic. In addition, the efficacy of a combined regimen such as immunotherapy and chemotherapy for such disorders still requires further validation in the future.

• gastric adenocarcinoma
• neuroendocrine cancer
• nivolumab
• oxaliplatin + capecitabine
• tumor markers

• Antagonism
• Combinatorial index
• EBV
• Synergism
• Zta

• fibronectin type III domain containing 1
• gastric cancer
• immunohistochemistry
• prognosis
• protein expression

• chinese population
• gastric cancer
• tumor-node-metastasis staging

• China
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Neoplasm Staging
• Oncology Nursing
• Prognosis
• Retrospective Studies
• Stomach Neoplasms/classification
• Stomach Neoplasms/diagnosis
• Stomach Neoplasms/pathology
• Stomach Neoplasms/surgery
• Survival Analysis

• long noncoding rna cat104
• gastric carcinoma (gc)
• microrna-381
• zinc finger e-box-binding homeobox 1 (zeb1)
• c-jun n-terminal kinase (jnk) pathway
• wnt/β-catenin pathways

• Apoptosis
• Biomarkers, Tumor/genetics
• Biomarkers, Tumor/metabolism
• Cell Adhesion
• Cell Movement
• Cell Proliferation
• Gene Expression Regulation, Neoplastic
• Humans
• MicroRNAs/genetics
• Neoplasm Invasiveness
• RNA, Long Noncoding/genetics
• Stomach Neoplasms/genetics
• Stomach Neoplasms/metabolism
• Stomach Neoplasms/pathology
• Tumor Cells, Cultured
• Wnt Signaling Pathway
• Zinc Finger E-box-Binding Homeobox 1/genetics
• Zinc Finger E-box-Binding Homeobox 1/metabolism

to evaluate the efficacy of nursing interventions to increase the level of hope in cancer patients, in a meta-analysis.

electronic databases were searched. Two of the authors independently extracted data from the eligible studies, and Stata 13.0 software was used to pool the data.

nine randomized controlled trials were included, and methodological quality of each randomized controlled trial (RCT) was evaluated using Cochrane handbook recommendations. A random effects model was used to combine results from eligible studies. The pooled results using the fixed effects model showed that scores to first effects increase significantly after the use of nursing intervention between the groups. Heterogeneity was observed among the studies for posttest (df = 8, P = 0.000; I² =76.1 %). The results indicated significant heterogeneity across the nine selected studies. The test for heterogeneity showed no homogeneity among studies for follow-up (df = 8, P = 0.328; I² = 12.9 %), and there was no statistical significance.

the current evidence suggests that nursing intervention has a positive effect on hope in cancer patients. However, more large-scale and high-quality randomized controlled trials are needed to confirm these results.