The ISGC classifier could effectively predict recurrence and survival of GC, and complemented the prognostic value of the TNM staging system. Moreover, the ISGC might be a useful predictive tool to identify stage II and III GC patients who would benefit from adjuvant chemotherapy.

The survival prediction model can be used to make individualized predictions of the expected survival benefit from the addition of adjuvant chemotherapy for patients with stage II or stage III gastric cancer.

Higher maternal folate coupled with vitamin B12 insufficiency was associated with higher GDM risk. This finding has potential implications for antenatal supplement recommendations but will require confirmation in future studies.

BackgroundInflammation-based indexes have been used to predict survival and recurrence in cancer patients. Systemic immune-inflammation index (SII) was reported to be associated with prognosis in some malignant tumors. In the present study, we aimed to explore the association between SII and the prognosis of patients with gastric cancer.MethodsWe retrospectively analyzed data from 444 gastric cancer patients who underwent gastrectomy at the First Affiliated Hospital of Sun Yat-sen University between January 1994 and December 2005. Preoperative SII was calculated. The Chi square test or Fisher’s exact test was used to determine the relationship between preoperative SII and clinicopathologic characteristics. Overall survival (OS) rates were estimated using the Kaplan–Meier method, and the effect of SII on OS was analyzed using the Cox proportional hazards model. Receiver operating characteristic (ROC) curves were used to compare the predictive ability of SII, NLR, and PLR.ResultsSII equal to or higher than 660 was significantly associated with old age, large tumor size, unfavorable Borrmann classification, advanced tumor invasion, lymph node metastasis, distant metastasis, advanced TNM stage, and high carcino-embryonic antigen level, high neutrophil–lymphocyte ratio, and high platelet–lymphocyte ratio (all P < 0.05). High SII was significantly associated with unfavorable prognosis (P < 0.001) and SII was an independent predictor for OS (P = 0.015). Subgroups analysis further showed significant associations between high SII and short OS in stage I, II, III subgroups (all P < 0.05). SII was superior to NLR and PLR for predicting OS in patients with gastric cancer.ConclusionPreoperative SII level is an independent prognostic factor for OS in patients with gastric cancer.

TNM staging system of gastric cancer (GC) is not adequate for definition of prognosis and cannot predict the candidates who are likely to benefit from chemotherapy. In this research, we constructed a GC-SVM classifier integrating 3 clinicopathologic features and 8 IHC features in the training cohort of 251 patients. And further validation of the GC-SVM classifier was performed in two validation cohort of 535 patients.Multivariate analysis revealed that the GC-SVM classifier was an independent prognostic factor. Furthermore, the classifier had higher predictive accuracy for OS and DFS than TNM stage and can added prognostic value to the TNM staging system. Moreover, the GC-SVM classifier might be able to predict which patients will benefit from adjuvant chemotherapy. Thus, the classifier could facilitate patient counseling and individualized management. Conclusion:The newly developed GC-SVM classifier was a powerful predictor of OS and DFS. Moreover, the GC-SVM classifier could predict which patients with stage II and III GC benefit from adjuvant chemotherapy.

The success of checkpoint inhibitors in cancer treatment is associated with the infiltration of tissue-resident memory T (Trm) cells. In this study, we found that about 30% of tumorinfiltrating lymphocytes (TIL) in the tumor microenvironment of gastric adenocarcinoma were CD69 þ CD103 þ Trm cells. Trm cells were low in patients with metastasis, and the presence of Trm cells was associated with better prognosis in patients with gastric adenocarcinoma. Trm cells expressed high PD-1, TIGIT, and CD39 and represented tumor-reactive TILs. Instead of utilizing glucose, Trm cells relied on fatty acid oxidation for cell survival. Deprivation of fatty acid resulted in Trm cell death. In a tumor cell-T-cell coculture system, gastric adenocarcinoma cells outcompeted Trm cells for lipid uptake and induced Trm cell death. Targeting PD-L1 decreased fatty acid binding protein (Fabp) 4 and Fabp5 expression in tumor cells of gastric adenocarcinoma. In contrast, the blockade of PD-L1 increased Fabp4/5 expression in Trm cells, promoting lipid uptake by Trm cells and resulting in better survival of Trm cells in vitro and in vivo. PD-L1 blockade unleashed Trm cells specifically in the patientderived xenograft (PDX) mice. PDX mice that did not respond to PD-L1 blockade had less Trm cells than responders. Together, these data demonstrated that Trm cells represent a subset of TILs in the antitumor immune response and that metabolic reprogramming could be a promising way to prolong the longevity of Trm cells and enhance antitumor immunity in gastric adenocarcinoma.

Background and Objectives This study was conducted to investigate whether and how macrophages recruited to tumor microenvironments (tumor‐associated macrophages, TAMs) were involved in angiogenesis and lymphangiogenesis of gastric cancer (GC). Methods TAMs, microvessel density (MVD), and lymphatic vessel density (LVD) in 115 cases of GC tissue were assessed by immunohistochemistry (IHC) staining of CD68, CD34, and D2‐40, respectively. Preoperative blood samples from 43 patients were obtained to detect serum levels of vascular endothelial growth factor (VEGF) and VEGF‐C. A co‐culture system was also developed to study effects and underlying mechanisms of THP‐1 macrophages on SGC7901 GC cells. Results TAMs numbers were closely related to serosa invasion, lymph node metastasis and tumor, nodes, and metastases stage and a positive correlation existed between the TAMs count and MVD and LVD. Additionally, TAMs were associated with preoperative serum levels of VEGF and VEGF‐C, the expression of VEGF and VEGF‐C protein in macrophages was up‐regulated in the co‐culture system, and inhibition of the NF‐κB pathway in macrophages induced a significant reduction in the expression of VEGF and VEGF‐C in both macrophages and GC cells (all P < 0.05). Conclusions TAMs may promote angiogenesis and lymphangiogenesis of GC, possibly by enhancing VEGF and VEGF‐C expression. J. Surg. Oncol. 2012; 106:462–468. © 2012 Wiley Periodicals, Inc.

Genetic factors may have a greater contribution to early development of refractive error compared to environmental factors.