Objective: To perform a meta-analysis and literature review regarding the diagnostic accuracy of MRI for pre-operative tumour depth invasion (T) and regional lymph node invasion (N) staging of gastric carcinoma (GC). Methods: Articles were identified through systematic search of Medline, PubMed, Cochrane Library, Web of Science, Springerlink and several Chinese databases. The study quality was assessed by the quality assessment for studies of diagnostic accuracy. 2 reviewers independently extracted and assessed the data from 11 eligible studies. A meta-analysis was then carried out. Subgroup and sensitivity analyses were also performed. Results: 11 studies (439 patients) were finally included in the current review. Among these studies, the significant evidence of heterogeneity was only discovered for Subgroup analyses showed that diffusion-weighted imaging was more helpful for T staging. Conclusion:The present systematic review suggests that MRI has a good diagnostic accuracy for pre-operative T staging of GC and should be widely used in clinical work. However, the ability for N staging is relatively poor on MRI. Advances in knowledge:In the pre-operative staging of GC, MRI was a useful tool and may enhance accuracy for the T staging of advanced GC.Gastric carcinoma (GC) is the fourth most common cancer and the second leading cause of cancer-related death with a 5-year survival rate of ,20% around the world. 1 The disease is more common in Asian countries, especially China, Japan and Republic of Korea.2,3 Accurate assessment of local tumour depth invasion (T) and regional lymph node invasion (N) plays an essential role in predicting prognosis and determining the most appropriate treatment planning. 4,5The pre-operative staging of GC has been based on a multimodality approach, such as endoscopic ultrasonography (EUS), CT, MRI and positron emission tomography (PET).6,7 EUS and CT have been widely used for GC staging in previous years.8 Of course, different imaging modalities have themselves relative merits. CT with ionized radiation requires the injection of iodine contrast medium.9 EUS is an invasive technique requiring sedation 1 and is highly operator dependent.10 PET highly depends upon the standardized uptake value and the pathological subtype of the cancer. 11MRI is a powerful imaging method with high soft-tissue contrast, with technical versatility for sequence selection and modification, and without ionizing radiation. However, it was unsuitable for the staging of GC owing to its long acquisition time and susceptibility to motion artefacts in previous years. With technology improved and shorter imaging time, these limitations have recently been partially overcome. 12Recently, there has been much research using MRI to assess pre-operative staging of GC. Nevertheless, the number of patients in each study has been insufficient, and the results varied among the articles. Also, the limited imaging field of view of MRI in a single session makes it difficult to stage the distant metastasis (M). 13Therefore, the o...

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RNA-binding Fox (RBFOX)2, a member of a family of RNA-binding proteins, is well known as a regulator of alternative pre-mRNA splicing. However, its possible role in gastric cancer is unknown. In this study, we investigated the biologic role and clinical significance of RBFOX2 in gastric cancer growth and elucidated its underlying molecular mechanisms. We found that RBFOX2 was highly expressed in gastric cancer cell lines and tumor tissue compared with the adjacent nontumor tissue. We also found that RBFOX2 overexpression was correlated with poor overall survival in patients with gastric cancers. Multivariate survival analyses revealed that higher RBFOX2 expression was an independent prognostic factor for the overall survival of patients with gastric cancers. Suppression of RBFOX2 by shRNA inhibited gastric cancer cell proliferation, colony formation and induced apoptosis. Mechanism studies revealed that these effects were achieved through the simultaneous modulation of multiple signaling pathways. Knockdown of RBFOX2 expression by shRNA markedly inhibited the phosphorylation of phosphatidylinositol 3-hydroxy kinase, threonine kinase and extracellular signal-regulated kinase and Jun N-terminal kinases proteins. In contrast, the ectopic expression of RBFOX2 had the opposite effects. Moreover, RBFOX2 knockdown also induced the cleavage of caspase-3 and caspase-9 proteins. Collectively, these results demonstrate that RBFOX2 plays a critical role in regulating gastric cancer cell proliferation and survival and may be a potential prognostic biomarker and therapeutic target for gastric cancer.

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