• False-negative
• Gastric cancer
• Lymph node
• Nodal staging system
• Β-binomial distribution

• Humans
• Gastrectomy/methods
• Stomach Neoplasms/surgery
• Stomach Neoplasms/pathology
• Retrospective Studies
• Male
• Female
• Lymph Nodes/pathology
• Lymph Nodes/surgery
• Middle Aged
• Lymph Node Excision/methods
• Aged
• Lymphatic Metastasis
• Neoplasm Staging
• Prognosis
• Follow-Up Studies
• Adult

• antibiotics
• cumulative dosage
• gastric cancer
• survival
• types

• Humans
• Stomach Neoplasms/surgery
• Stomach Neoplasms/pathology
• Stomach Neoplasms/mortality
• Stomach Neoplasms/drug therapy
• Male
• Female
• Middle Aged
• Retrospective Studies
• Anti-Bacterial Agents/therapeutic use
• Aged
• Neoplasm Staging
• Gastrectomy/methods
• Prognosis
• Adult
• Kaplan-Meier Estimate
• Treatment Outcome

• Beijing Science and Technology New Star Program Cross-Cooperation Project
• Key Research and Development Projects of Hainan Province

• Diabetes mellitus
• Gastric cancer
• Postoperative recovery
• Propensity score matching
• Survival outcomes

• Humans
• Stomach Neoplasms/surgery
• Stomach Neoplasms/mortality
• Stomach Neoplasms/pathology
• Male
• Female
• Propensity Score
• Middle Aged
• Gastrectomy/adverse effects
• Retrospective Studies
• Aged
• Diabetes Mellitus/epidemiology
• Postoperative Complications/etiology
• Postoperative Complications/epidemiology
• Treatment Outcome
• Risk Factors

• gastric cancer
• gene signature
• platelets
• prediction model
• prognosis
• tumor microenvironment

• Humans
• Stomach Neoplasms/genetics
• Stomach Neoplasms/drug therapy
• Stomach Neoplasms/immunology
• Stomach Neoplasms/mortality
• Stomach Neoplasms/diagnosis
• Blood Platelets/immunology
• Blood Platelets/metabolism
• Prognosis
• Tumor Microenvironment/immunology
• Tumor Microenvironment/genetics
• Transcriptome
• Female
• Male
• Biomarkers, Tumor/genetics
• Gene Expression Regulation, Neoplastic
• Middle Aged
• Gene Expression Profiling
• Drug Resistance, Neoplasm/genetics
• Nomograms
• Antineoplastic Agents/therapeutic use
• Aged
• Databases, Genetic

• clinicopathological factors
• locally advanced gastric cancer
• lymph node metastasis
• nomogram

• funding

• Postoperative complications
• Radical gastrectomy
• Risk factors
• Survival outcomes

• Humans
• Stomach Neoplasms/surgery
• Stomach Neoplasms/mortality
• Stomach Neoplasms/pathology
• Gastrectomy/adverse effects
• Gastrectomy/mortality
• Male
• Female
• Postoperative Complications/etiology
• Postoperative Complications/epidemiology
• Postoperative Complications/mortality
• Middle Aged
• Aged
• Risk Factors
• Retrospective Studies
• Adult

• Clinicopathologic factors
• Early stage
• Gastric cancer
• Lymph node metastasis
• Prediction model

• Humans
• Stomach Neoplasms/pathology
• Stomach Neoplasms/therapy
• Female
• Lymphatic Metastasis
• Male
• Retrospective Studies
• Middle Aged
• Risk Factors
• Aged
• Neoplasm Staging
• Adult
• Sex Factors
• Tumor Burden
• Gastrectomy
• Logistic Models
• Lymph Nodes/pathology
• Aged, 80 and over
• Lymph Node Excision

• K-Nearest Neighbors (KNN)
• Naïve Bayes (NB)
• area under ROC curve (AUC)
• feature extraction
• gastric cancer
• radiomics features
• random forest (RF) classifier
• support vector machine (SVM)

• P20 GM135009 NIGMS NIH HHS
• P30 CA225520 NCI NIH HHS

• Cell lines
• Gastric cancer
• Gastric cancer organoids
• Human-derived organoids
• In vitro research models

• Adjuvant chemotherapy
• CA19-9
• Gastric cancer
• Lymphovascular invasion
• Stage IB

• METTL3
• MNNG
• SNHG7
• gastric cancer
• m6A RNA methylation

• 81472939 National Natural Science Foundation of China
• lzuyxcx-2022-188 the Medical Innovation and Development Project of Lanzhou University
• lzujbky-2023-39 Fundamental Research Funds for the Central Universities
• zujbky-2022-25 Fundamental Research Funds for the Central Universities
• 2242023k30020 Fundamental Research Funds for the Central Universities
• 2242023k30021 Fundamental Research Funds for the Central Universities

• Gastric cancer
• Overall survival
• Prognosis
• Stage
• Tumor deposits

• Humans
• Stomach Neoplasms/genetics
• Tumor Suppressor Protein p53/genetics
• Apoptosis/genetics
• Cell Line
• Signal Transduction/genetics
• Antigens, Differentiation
• Plasminogen Activator Inhibitor 1/genetics

• Biomarker
• Circular RNA
• Droplet digital polymerase chain reaction
• Exosomes
• Gastric cancer

• Humans
• Stomach Neoplasms/diagnosis
• Stomach Neoplasms/genetics
• Early Detection of Cancer
• RNA, Circular
• CA-19-9 Antigen
• Computational Biology

• N staging
• gastric cancer
• lymph nodes metastasis
• prognosis

The level of Ki-67 expression has served as a prognostic factor in gastric cancer. The quantitative parameters based on the novel dual-layer spectral detector computed tomography (DLSDCT) in discriminating the Ki-67 expression status are unclear.

To investigate the diagnostic ability of DLSDCT-derived parameters for Ki-67 expression status in gastric carcinoma (GC).

Dual-phase enhanced abdominal DLSDCT was performed preoperatively in 108 patients with gastric adenocarcinoma. Primary tumor monoenergetic CT attenuation value at 40-100 kilo electron volt (kev), the slope of the spectral curve (λ_HU), iodine concentration (IC), normalized IC (nIC), effective atomic number (Z^eff) and normalized Z^eff (nZ^eff) in the arterial phase (AP) and venous phase (VP) were retrospectively compared between patients with low and high Ki-67 expression in gastric adenocarcinoma. Spearman’s correlation coefficient was used to analyze the association between the above parameters and Ki-67 expression status. Receiver operating characteristic (ROC) curve analysis was performed to compare the diagnostic efficacy of the statistically significant parameters between two groups.

Thirty-seven and 71 patients were classified as having low and high Ki-67 expression, respectively. CT_{40 kev-VP}, CT_{70 kev-VP}, CT_{100 kev-VP}, and Z^eff-related parameters were significantly higher, but IC-related parameters were lower in the group with low Ki-67 expression status than the group with high Ki-67 expression status, and other analyzed parameters showed no statistical difference between the two groups. Spearman’s correlation analysis showed that CT_{40 kev-VP}, CT_{70 kev-VP}, CT_{100 kev-VP}, Z^eff, and nZ^eff exhibited a negative correlation with Ki-67 status, whereas IC and nIC had positive correlation with Ki-67 status. The ROC analysis demonstrated that the multi-variable model of spectral parameters performed well in identifying the Ki-67 status [area under the curve (AUC) = 0.967; sensitivity 95.77%; specificity 91.89%)]. Nevertheless, the differentiating capabilities of single-variable model were moderate (AUC value 0.630 - 0.835). In addition, the nZ^eff_VP and nIC_VP (AUC 0.835 and 0.805) showed better performance than CT_{40 kev-VP}, CT_{70 kev-VP} and CT_{100 kev-VP} (AUC 0.630, 0.631 and 0.662) in discriminating the Ki-67 status.

Quantitative spectral parameters are feasible to distinguish low and high Ki-67 expression in gastric adenocarcinoma. Z^eff and IC may be useful parameters for evaluating the Ki-67 expression.

• Spectral computer tomography
• Quantitative parameters
• Gastric carcinoma
• Iodine concentration
• Effective atomic number
• Ki-67 expression

The level of Ki-67 expression has served as a prognostic factor in gastric cancer. The quantitative parameters based on the novel dual-layer spectral detector computed tomography (DLSDCT) in discriminating the Ki-67 expression status are unclear.

To investigate the diagnostic ability of DLSDCT-derived parameters for Ki-67 expression status in gastric carcinoma (GC).

Dual-phase enhanced abdominal DLSDCT was performed preoperatively in 108 patients with gastric adenocarcinoma. Primary tumor monoenergetic CT attenuation value at 40-100 kilo electron volt (kev), the slope of the spectral curve (λ_HU), iodine concentration (IC), normalized IC (nIC), effective atomic number (Z^eff) and normalized Z^eff (nZ^eff) in the arterial phase (AP) and venous phase (VP) were retrospectively compared between patients with low and high Ki-67 expression in gastric adenocarcinoma. Spearman’s correlation coefficient was used to analyze the association between the above parameters and Ki-67 expression status. Receiver operating characteristic (ROC) curve analysis was performed to compare the diagnostic efficacy of the statistically significant parameters between two groups.

Thirty-seven and 71 patients were classified as having low and high Ki-67 expression, respectively. CT_{40 kev-VP}, CT_{70 kev-VP}, CT_{100 kev-VP}, and Z^eff-related parameters were significantly higher, but IC-related parameters were lower in the group with low Ki-67 expression status than the group with high Ki-67 expression status, and other analyzed parameters showed no statistical difference between the two groups. Spearman’s correlation analysis showed that CT_{40 kev-VP}, CT_{70 kev-VP}, CT_{100 kev-VP}, Z^eff, and nZ^eff exhibited a negative correlation with Ki-67 status, whereas IC and nIC had positive correlation with Ki-67 status. The ROC analysis demonstrated that the multi-variable model of spectral parameters performed well in identifying the Ki-67 status [area under the curve (AUC) = 0.967; sensitivity 95.77%; specificity 91.89%)]. Nevertheless, the differentiating capabilities of single-variable model were moderate (AUC value 0.630 - 0.835). In addition, the nZ^eff_VP and nIC_VP (AUC 0.835 and 0.805) showed better performance than CT_{40 kev-VP}, CT_{70 kev-VP} and CT_{100 kev-VP} (AUC 0.630, 0.631 and 0.662) in discriminating the Ki-67 status.

Quantitative spectral parameters are feasible to distinguish low and high Ki-67 expression in gastric adenocarcinoma. Z^eff and IC may be useful parameters for evaluating the Ki-67 expression.

• Spectral computer tomography
• Quantitative parameters
• Gastric carcinoma
• Iodine concentration
• Effective atomic number
• Ki-67 expression

• Humans
• Ki-67 Antigen
• Sensitivity and Specificity
• Stomach Neoplasms/diagnostic imaging
• Retrospective Studies
• Diagnosis, Differential
• Adenocarcinoma/diagnostic imaging
• Adenocarcinoma/pathology
• ROC Curve
• Iodine
• Tomography, X-Ray Computed/methods

Cancerous inhibitor of protein phosphatase 2A (CIP2A) is a newly discovered oncogene. It is an active cell proliferation regulatory factor that inhibits tumor apoptosis in gastric cancer (GC) cells. CIP2A is functionally related to chemoresistance in various types of tumors according to recent studies. The underlying mechanism, however, is unknown. Further, the primary treatment regimen for GC is oxaliplatin-based chemotherapy. Nonetheless, it often fails due to chemoresistance of GC cells to oxaliplatin.

The goal of this study was to examine CIP2A expression and its association with oxaliplatin resistance in human GC cells.

Immunohistochemistry was used to examine CIP2A expression in GC tissues and adjacent normal tissues. CIP2A expression in GC cell lines was reduced using small interfering RNA. After confirming the silencing efficiency, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide tetrazolium and flow cytometry assays were used to evaluate cell proliferation and apoptosis caused by oxaliplatin treatment. Further, the key genes and protein changes were verified using real-time quantitative reverse transcription PCR and Western blotting, respectively, before and after intervention. For bioinformatics analysis, we used the R software and Bioconductor project. For statistical analysis, we used GraphPad Prism 6.0 and the Statistical Package for the Social Sciences software version 20.0 (IBM, Armonk, United States).

A high level of CIP2A expression was associated with tumor size, T stage, lymph node metastasis, Tumor Node Metastasis stage, and a poor prognosis. Further, CIP2A expression was higher in GC cells than in normal human gastric epithelial cells. Using small interfering RNA against CIP2A, we discovered that CIP2A knockdown inhibited cell proliferation and significantly increased GC cell sensitivity to oxaliplatin. Moreover, CIP2A knockdown enhanced oxaliplatin-induced apoptosis in GC cells. Hence, high CIP2A levels in GC may be a factor in chemoresistance to oxaliplatin. In human GC cells, CIP2A regulated protein kinase B phosphorylation, and chemical inhibition of the protein kinase B signaling pathway was significantly associated with increased sensitivity to oxaliplatin. Therefore, the protein kinase B signaling pathway was correlated with CIP2A-enhanced chemoresistance of human GC cells to oxaliplatin.

CIP2A expression could be a novel therapeutic strategy for chemoresistance in GC.

• Cancerous inhibitor of protein phosphatase 2A
• Gastric cancer
• Oxaliplatin
• Chemoresistance
• Akt

• AJCC
• Cancer staging
• Gastric cancer
• Nomogram
• Prognosis

• Deep learning
• Gastric cancer
• Medical image
• Multi-modal data
• Survival prediction

The prognostic value of quantitative assessments of the number of retrieved lymph nodes (RLNs) in gastric cancer (GC) patients needs further study.

To discuss how to obtain a more accurate count of metastatic lymph nodes (MLNs) based on RLNs in different pT stages and then to evaluate patient prognosis.

This study retrospectively analyzed patients who underwent GC radical surgery and D2/D2+ LN dissection at the Cancer Hospital of Harbin Medical University from January 2011 to May 2017. Locally weighted smoothing was used to analyze the relationship between RLNs and the number of MLNs. Restricted cubic splines were used to analyze the relationship between RLNs and hazard ratios (HRs), and X-tile was used to determine the optimal cutoff value for RLNs. Patient survival was analyzed with the Kaplan-Meier method and log-rank test. Finally, HRs and 95% confidence intervals were calculated using Cox proportional hazards models to analyze independent risk factors associated with patient outcomes.

A total of 4968 patients were included in the training cohort, and 11154 patients were included in the validation cohort. The smooth curve showed that the number of MLNs increased with an increasing number of RLNs, and a nonlinear relationship between RLNs and HRs was observed. X-tile analysis showed that the optimal number of RLNs for pT1-pT4 stage GC patients was 26, 31, 39, and 45, respectively. A greater number of RLNs can reduce the risk of death in patients with pT1, pT2, and pT4 stage cancers but may not reduce the risk of death in patients with pT3 stage cancer. Multivariate analysis showed that RLNs were an independent risk factor associated with the prognosis of patients with pT1-pT4 stage cancer (P = 0.044, P = 0.037, P = 0.003, P < 0.001).

A greater number of RLNs may not benefit the survival of patients with pT3 stage disease but can benefit the survival of patients with pT1, pT2, and pT4 stage disease. For the pT1, pT2, and pT4 stages, it is recommended to retrieve 26, 31 and 45 LNs, respectively.

• Gastric cancer
• Metastatic lymph nodes
• Number of retrieved lymph nodes
• Prognosis

• Borrmann type
• gastric cancer
• lymph node metastasis
• peritoneal metastasis
• signet ring cell carcinoma

Esophageal and Gastric Adenocarcinomas (AGE/S) are characterized by early metastasis and poor survival. MACC1 (Metastasis Associated in Colon Cancer 1) acts in colon cancer as a metastasis inducer and is linked to reduced survival. In this study, we analyzed the prognostic role of MACC1 in a large AGE/S cohort and the potential of MACC1 inhibition in vitro and in vivo. MACC1 is an independent negative prognostic marker in our cohort. In vitro, migration was enhanced by MACC1 in overexpressing cells. This MACC1-related effect could be inhibited by using selumetinib in vitro. In vivo, MACC1 induced faster and larger metastasis development, which could be inhibited by selumetinib. In conclusion, MACC1 is a strong negative prognostic factor in AGE/S and is a potential target for therapy with selumetinib.

Esophageal and Gastric Adenocarcinomas (AGE/S) are characterized by early metastasis and poor survival. MACC1 (Metastasis Associated in Colon Cancer 1) acts in colon cancer as a metastasis inducer and is linked to reduced survival. This project illuminates the role and potential for the inhibition of MACC1 in AGE/S. Using 266 of 360 TMAs and survival data of AGE/S patients, we confirm the value of MACC1 as an independent negative prognostic marker in AGE/S patients. MACC1 gene expression is correlated with survival and morphological characteristics. In vitro analysis of lentivirally MACC1-manipulated subclones of FLO-1 and OE33 showed enhanced migration induced by MACC1 in both cell line models, which could be inhibited by the MEK1 inhibitor selumetinib. In vivo, the efficacy of selumetinib on tumor growths and metastases of MACC1-overexpressing FLO-1 cells xenografted intrasplenically in NOG mice was tested. Mice with high-MACC1-expressing cells developed faster and larger distant metastases. Treatment with selumetinib led to a significant reduction in metastasis exclusively in the MACC1-positive xenografts. MACC1 is an enhancer of tumor aggressiveness and a predictor of poor survival in AGE/S. This effect can be inhibited by selumetinib.

Deregulated Wnt-signaling is a key mechanism driving metastasis in adenocarcinoma of the gastroesophageal junction and stomach (AGE/S). The oncogene S100A4 was identified as a Wnt-signaling target gene and is known to promote metastasis. In this project, we illuminate the role of S100A4 for metastases development and disease prognosis of AGE/S. Five gastric cancer cell lines were assessed for S100A4 expression. Two cell lines with endogenous high S100A4 expression were used for functional phenotyping including analysis of proliferation and migration after stable S100A4 knock-down. The prognostic value of S100A4 was evaluated by analyzing the S100A4 expression of tissue microarrays with samples of 277 patients with AGE/S. S100A4 knock-down induced lower migration in FLO1 and NCI-N87 cells. Treatment with niclosamide in these cells led to partial inhibition of S100A4 and to reduced migration. Patients with high S100A4 expression showed lower 5-year overall and disease-specific survival. In addition, a larger share of patients in the S100A4 high expressing group suffered from metachronous metastasis. This study identifies S100A4 as a negative prognostic marker for patients with AGE/S. The strong correlation between S100A4 expression, metastases development and patient survival might open opportunities to use S100A4 to improve the prognosis of these patients and as a therapeutic target for intervention in this tumor entity.

• S100A4
• esophageal cancer
• gastric cancer
• metastasis
• niclosamide

• Adenocarcinoma/metabolism
• Esophagus/pathology
• Humans
• Prognosis
• S100 Calcium-Binding Protein A4/genetics
• S100 Proteins/genetics
• S100 Proteins/metabolism
• Stomach/pathology

Gastric cancer is the fifth most frequently diagnosed cancer worldwide, behind breast, lung, colorectal, and prostate cancers. In gastric cancer, multimodality treatment shows prospective benefits and also improves survival. Surgery, however, is the mainstay of curative treatment. The staging of gastric cancer patients is critical for harmonization of care. Accurate stages assure that informed clinical decisions are timely made. The American Joint Committee on Cancer (AJCC) staging system is the most widely applied system in to determine the disease's prognosis and survival prediction. The recently adopted 8th AJCC TNM staging system has been revised to enhance its survival predictive power. Subsequent studies have established the validity of the current edition, demonstrating improved stage stratification, discriminatory power, and survival prediction. However, other studies have cast doubt on the superiority of the new edition. Innovations aimed at further improving its prognosis have resulted in developing of novel models. Advances in our understanding of the tumor microenvironment and molecular categorization of cancer have resulted in proposals for their inclusion in TNM staging as potential complementary factors that enhance survival prediction and prognostic assessment ability. The purpose of this study is to conduct a review of the published literature regarding the validity of the 8th AJCC TNM staging system, proposed modifications, and nomograms.

•

The 8th AJCC is valid in prognostic stratification of gastric cancer, however, revisions are still required.

• adjuvant chemotherapy
• gastric cancer
• pT2N0M0
• prognosis
• surgery alone

• deep learning - CNN
• gastric cancer
• multi-modal data analysis
• radiomics
• survival analysis (source: MeSH NLM)

Objective: We sought to investigate the prognostic significance of body composition and weight change during the first 6 months of adjuvant chemotherapy after R0 resection and develop novel nomograms to accurately predict relapse-free survival (RFS) and overall survival (OS).

Methods: This retrospective study included 190 patients who underwent curative radical gastrectomy for gastric cancer and received adjuvant chemotherapy. The changes in weight and body composition including skeletal muscle index (SMI), subcutaneous adipose tissue (SAT), and visceral adipose tissue (VAT) were analyzed for 6 months. LASSO Cox regression and multivariate Cox regression were conducted to evaluate other clinical characteristics, which were used to construct a nomogram for the prediction of 3- and 5-year RFS and OS. The constructed nomogram was subjected to 1,000 resamples bootstrap for internal validation. The Concordance index (C-index) and time-dependent receiver operating characteristic (t-ROC) curves were used to evaluate and compare the discriminative abilities of the new nomograms, non-nutritional nomograms, and pTNM stage.

Results: The median follow-up duration was 42.0 (25.2–55.1) months. Factors included in the newly-built nomogram for RFS were pT stage, pN stage, tumor site, tumor size, nerve invasion or not, surgery type, and change of L3SMI, while factors included in the nomogram for OS were pT stage, pN stage, tumor size, nerve invasion or not, surgery type, and change of L3SMI. The C-index and t-ROC indicated that our newly-built nomograms had greater potential to accurately predict prognosis than the non-nutritional nomograms and pTNM stage system. Besides, oral nutritional supplements can reduce the degree of weight and L3SMI loss.

Conclusion: Change in skeletal muscle mass during adjuvant chemotherapy can be incorporated into predictive prognostic nomograms for RFS and OS in GC patients after radical resection. Dynamic changes in body composition and weight during adjuvant chemotherapy contribute to the early detection of poor outcomes.

• adjuvant chemotherapy
• body composition
• gastric cancer
• nomogram
• weight

• BAG4
• Gastric cancer
• Invasion
• Metastasis
• PI3K/AKT/NF-κB signaling

• Adaptor Proteins, Signal Transducing/antagonists & inhibitors
• Adaptor Proteins, Signal Transducing/genetics
• Cell Line, Tumor
• Cell Movement/genetics
• Cell Proliferation/genetics
• Gene Expression Regulation, Neoplastic/genetics
• Humans
• NF-kappa B/genetics
• Neoplasm Invasiveness/genetics
• Neoplasm Invasiveness/pathology
• Oncogene Protein v-akt/genetics
• Phosphatidylinositol 3-Kinases/genetics
• Signal Transduction/genetics
• Stomach Neoplasms/genetics
• Stomach Neoplasms/pathology
• Transcription Factor RelA/genetics
• Zinc Finger E-box-Binding Homeobox 1/genetics

• adipose tissue distribution
• gastric cancer
• obesity
• overweight
• prognosis

• Accuracy
• American Joint Committee on Cancer
• Endoscopic ultrasound
• Gastric cancer
• Staging

• Endosonography
• Humans
• Neoplasm Staging
• Prognosis
• Retrospective Studies
• Stomach Neoplasms/diagnostic imaging
• Stomach Neoplasms/pathology
• United States

• No. 81800467 National Natural Science Foundation of China

Gastric cancer (GC) is a kind of malignancy with a high mortality and recurrence. An effective prediction model based on ideal biomarkers to assess prognosis could benefit patients for optimization of treatment. Bioinformatics has played an increasingly important role in the study of cancer diseases. Therefore, this study started with bioinformatics to establish a reliable prognostic model of gastric cancer. The gene expression data and clinical data of GC tissues and normal tissues were obtained from the Gene Expression Omnibus (GEO), Genotype‐Tissue Expression (GTEx), and The Cancer Genome Atlas (TCGA) profile database. We finally identified a four gene signature and constructed a prognostic model. The results of internal and external validation showed that the model is highly reliable. In addition, we also constructed a nomogram based on the model, which was verified by a calibration curve to show its predicted accuracy. Comprehensive analysis indicated that the four genes in the model are related to the occurrence and development of tumors, perhaps they are potential targets for tumor treatment. Generally, this prognostic model can bring potential benefits to patients with gastric cancer.

• bioinformatics
• biomarker
• gastric cancer
• nomogram
• prognostic model

• AFP-producing
• adenocarcinoma
• clinical characteristic
• gastrointestinal
• pathological characteristic

P53-induced gene 11 (PIG11) is an early transcription-related target of p53 that is involved in cell apoptosis and tumor development. However, its biological function in gastric cancer (GC) tissues and relationship with the prognosis of patients with GC have remained elusive. In the present retrospective study, 60 fresh and 790 paraffin-embedded samples of GC were obtained from the Affiliated Hospital of Nantong University (Nantong, China) with complete clinical data from all patients. Reverse transcription-quantitative PCR and tissue microarray-immunohistochemical analysis were used to determine the expression of PIG11 in the respective GC tissues. A receiver operating characteristic (ROC) curve was plotted to determine the diagnostic utility of PIG11 expression in GC. Furthermore, three online databases, including Gene Expression Profiling Interactive Analysis (GEPIA), Oncomine and Kaplan-Meier plotter, were used for bioinformatics analysis of PIG11. PIG11 expression in GC tissues was high, which was positively correlated with invasive depth (P<0.001), lymph node metastasis (P<0.001), distant metastasis (P=0.019), TNM staging (P<0.001) and carcinoembryonic antigen in serum (P<0.001), and negatively associated with the overall survival of patients with GC. The ROC curve analysis suggested that based on PIG11 expression, it was possible to distinguish GC tissues from adjacent normal tissues (P<0.0001) with a sensitivity and specificity of 81.67 and 76.67%, respectively. In addition, Cox logistic regression analysis demonstrated that high PIG11 expression is a novel biomarker for unfavorable prognosis of patients with GC. Furthermore, the results obtained from the GEPIA database indicated that PIG11 expression is correlated with TNF, carcinoembryonic antigen related cell adhesion molecule 5, phosphatidylinositol-4, 5-bisphosphate 3-kinase catalytic subunit alpha, VEGFA and kinase insert domain receptor. Therefore, PIG11 expression may be associated with the malignancy of GC and may serve as a potential diagnostic and prognostic biomarker for GC.

• P53-induced gene 11
• gastric cancer
• immunohistochemistry
• prognosis
• tissue microarray

• Gastric cancer
• Lymph node metastasis
• N3b stage
• Prognosis

• Adenocarcinoma/classification
• Adenocarcinoma/pathology
• Adenocarcinoma/surgery
• Aged
• Female
• Gastrectomy
• Humans
• Kaplan-Meier Estimate
• Lymph Node Excision
• Lymph Nodes/pathology
• Lymphatic Metastasis/pathology
• Male
• Middle Aged
• Neoplasm Invasiveness
• Neoplasm Staging/methods
• Prognosis
• Proportional Hazards Models
• Stomach Neoplasms/classification
• Stomach Neoplasms/pathology
• Stomach Neoplasms/surgery
• Survival Rate
• Tumor Burden