Background The neutrophil–lymphocyte ratio (NLR) and platelet–lymphocyte ratio (PLR) are representative blood markers of systemic inflammatory responses. However, the clinical significance of the combination of these markers is unclear. This study aimed to investigate the NLR and PLR in patients with advanced gastric cancer treated with chemotherapy and assess the clinical utility of a new blood score combining the NLR and PLR (NLR-PLR score) as a predictor of tumor response and prognosis. Methods We retrospectively analyzed 175 patients with gastric cancer receiving chemotherapy or chemoradiotherapy. These patients were categorized into progressive disease (PD) and non-PD groups according to tumor response. The NLR and PLR before treatment were examined, and the cut-off values were determined. The NLR-PLR score ranged from 0 to 2 as follows: score of 2, high NLR (> 2.461) and high PLR (> 248.4); score of 1, either high NLR or high PLR; score of 0, neither high NLR nor high PLR. Results With regard to tumor response, 64 and 111 patients had PD and non-PD, respectively. The NLR-PLR score was significantly higher in patients with PD than in those with non-PD ( p = 0.0009). The prognosis was significantly poorer in patients with a higher NLR-PLR score than in those with a lower NLR-PLR score ( p <  0.0001). Multivariate analysis demonstrated that the NLR-PLR score was an independent prognostic factor for prediction of overall survival ( p = 0.0392). Conclusion Low-cost stratification according to the NLR-PLR score might be a promising approach for predicting tumor response and prognosis in patients with advanced gastric cancer.

Stanniocalcin 2 (STC2) is a glycoprotein hormone that plays an important role in calcium and phosphate homeostasis. Furthermore, recent studies have demonstrated that STC2 expression in the primary site is correlated with tumor progression in several types of malignancies. However, few reports have investigated the clinical significance of STC2 expression in the blood of patients with gastric cancer. Therefore, we examined STC2 expression as a molecular blood marker for detection of circulating tumor cells (CTCs) and assessed the relationship between STC2 expression and clinico-pathological features including prognosis in patients with gastric cancer. Quantitative PCR assay was used to assess STC2 mRNA expression in 4 gastric cancer cell lines and in blood specimens from 93 patients with gastric cancer and 22 healthy volunteers. The numbers of STC2 mRNA copies were significantly higher in the gastric cancer cell lines and in blood from patients with gastric cancer than in blood from healthy volunteers (P=0.0002 and P=0.01, respectively). STC2 expression was positive in 43 (46.2%) of the 93 patients with gastric cancer, and its expression was significantly correlated with age, depth of tumor invasion, lymph node metastasis, stage and venous invasion (P=0.023, P=0.045, P=0.035, P=0.007 and P=0.027, respectively). The 5-year survival rate was significantly lower in patients with STC2 expression compared to patients without STC2 expression (P=0.014). Our results indicate that STC2 could be a useful molecular blood marker for predicting tumor progression by monitoring CTCs in patients with gastric cancer.

Background and Aim: Tumor cells escape host immunosurveillance and thus produce an advantageous environment for tumor progression. Recent studies have demonstrated that tumor-infiltrating lymphocytes (TILs) play a principal role in the immune response to tumors. However, little is understood about numerical alterations in CD3+ TILs during tumor progression in patients with gastric cancer. The present study examines the density of CD3+ TILs to elucidate their clinical significance in gastric cancer. Methods:The numbers of CD3+ TILs in 120 resected specimens from patients with gastric cancer and 27 endoscopic resected specimens from patients with gastric adenoma were immunohistochemically assessed using a CD3 polyclonal antibody. Results: The mean number of CD3+ TILs (± SD) in the patients with gastric cancer and adenoma was 87.5 ± 59.8 and 379.6 ± 128.1, respectively. Significantly more CD3+ TILs were found in specimens from patients with gastric adenoma than with gastric cancer (P < 0.0001). The numbers of CD3+ TILs significantly correlated with depth of tumor invasion, lymph node metastasis, and stage (P = 0.022, P = 0.0004, and P = 0.011, respectively). The 5-year survival rate was significantly poorer for patients with fewer CD3+ TILs (P = 0.004). Multivariate analysis selected the density of CD3+ TILs as an independent prognostic factor (P = 0.034). Conclusions: Our results demonstrated that the density of CD3+ TILs decreases during tumor progression. The density of CD3+ TILs is an immunological predictor of lymph node metastasis and disease outcome in patients with gastric cancer.

A case of primary osteosarcoma arising in the left ovary of a 75 year‐old female is described. The chief complaint was a sensation of lower abdominal mass. An abdominal plain film showed a large calcified mass in pelvic region, and a preoperative diagnosis of “ovarian fibroma” was made. The excised tumor was divided into 4 pieces, resembling an oyster shell. Microscopically, the tumor fragments were composed of compact bone or woven bone with surrounding atypical osteoblasts and osteoclasts. The tumor was partly composed of numerous spindle cells with malignant osteoid or atypical chondroid formation, and diagnosed as “osteosarcoma”. The cystic part of the lesion was lined with a single layer of columnar cells, but the tumor contained no other germ elements or stem cells, or malignant epithelium. Therefore, it is doubtful that this tumor originated from teratoma or malignant mixed mesodermal tumor, and we conclude that this ovarian osteosarcoma arose through a neoplastic change in ovarian stromal cells. The patient died 4 months after surgery due to intra‐abdominal and intrathoracic dissemination of the tumor.

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