Background and Objectives: Previous studies of the prognostic value of the signet ring cell (SRC) type have yielded inconsistent results. Therefore, the aim of the present meta-analysis is to explore the clinicopathological characteristics and prognostic value of SRCs.Methods: Relevant articles that compared SRC and non-SRC type in PubMed and Web of Science were comprehensively searched. Then, a meta-analysis was performed.Results: A total of 19 studies including 35947 cases were analyzed. Compared with non-SRC patients, SRC patients tended to be younger (WMD: -3.88, P=0.001) and predominantly female (OR: 1.60, P<0.001). Additionally, SRC patients exhibited less upper third tumor location (OR: 0.62, P<0.001) and less frequent hematogenous metastasis (OR: 0.41, P<0.001). There was no difference in overall survival (OS) between SRC and non-SRC patients in the total population (HR: 1.02, P=0.830). Early gastric cancer with SRCs was associated with better OS (HR: 0.57, P=0.002), while advanced gastric cancer with non-SRCs was associated with a worse prognosis (HR: 1.17, P<0.001).Conclusions: This meta-analysis revealed that SRC tends to affect young females and tends to be located in the middle and lower third of the stomach. Early SRCs are associated with better prognoses, while advanced SRCs are associated with worse prognoses.

Background: The prognostic value of the nutritional risk screening 2002 (NRS 2002) scale in metastatic gastric cancer remains unclear. We aimed to explore the role of NRS 2002 in metastatic gastric cancer.Methods: In this study, 1664 metastatic gastric cancer patients at our institution between 2000 and 2015 were retrospectively analyzed. The characteristics and clinical outcomes of the included patients were analyzed.Results: Receiver operating characteristic (ROC) curves showed that the regrouping NRS 2002 scale (≤ 3 vs. > 3) provided a similar risk stratification predicting 2-year overall survival (OS) (area under the curves [AUCs]: 0.563 vs. 0.564, P > 0.05) but a better stratification predicting the risk of complications of palliative surgery (AUCs: 0.563 vs. 0.522, P = 0.050) than the original NRS 2002 scale (< 3 vs. ≥ 3). Patients with NRS 2002 > 3 tended to have higher postoperative morbidity (13.3% vs. 8.5%, P = 0.027) and mortality (5.3% vs. 2.0%, P = 0.013) and shorter progression-free survival (PFS) (median PFS: 6.70 vs. 7.70 months, P = 0.002) and overall survival (OS) (median OS: 9.03 vs. 12.63 months, P < 0.001) than those with NRS 2002 ≤ 3. Multivariable analysis demonstrated that the regrouping NRS 2002 scale was the independent prognostic factor for PFS (hazard ratio [HR]: 1.16, P = 0.028) and OS (HR: 1.29, P < 0.001).Conclusions: The present study indicated that the NRS 2002 scale (regrouping scale) was an independent prognostic factor to predict the morbidity, mortality and survival outcomes for metastatic gastric cancer.

Background and objective The role of additional gastrectomy after non-curative endoscopic resection remains uncertain. The present meta-analysis aimed to explore the risk factors for early-stage gastric-cancer patients after non-curative endoscopic resection and evaluate the efficacy of additional gastrectomy. Methods Relevant studies that reported additional gastrectomy after non-curative endoscopic resection were comprehensively searched in MedLine, Web of Science and EMBASE. We first investigated the risk factors for residual tumor and lymph-node metastasis after non-curative endoscopic resection and then analysed the survival outcome, including 5-year overall survival (OS) and 5-year disease-free survival, of additional gastrectomy. Results Twenty-one studies comprising 4870 cases were included in the present study. We found that residual tumor was associated with larger tumor size (>3 cm) (odds ratio [OR] = 2.81, P < 0.001), undifferentiated tumor type (OR = 1.78, P = 0.011) and positive horizontal margin (OR = 9.78, P < 0.001). Lymph-node metastasis was associated with larger tumor size (>3 cm) (OR = 1.73, P < 0.001), elevated tumor type (OR = 1.60, P = 0.035), deeper tumor invasion (>SM1) (OR = 2.68, P < 0.001), lymphatic invasion (OR = 4.65, P < 0.001) and positive vertical margin (OR = 2.30, P < 0.001). Patients who underwent additional gastrectomy had longer 5-year OS (hazard ratio [HR] = 0.34, P < 0.001), 5-year disease-free survival (HR = 0.52, P = 0.001) and 5-year disease-specific survival (HR = 0.50, P < 0.001) than those who did not. Moreover, elderly patients also benefited from additional gastrectomy regarding 5-year OS (HR = 0.41, P = 0.001). Conclusions Additional gastrectomy with lymph-node dissection might improve the survival of early-stage gastric-cancer patients after non-curative endoscopic resection. However, risk stratification should be performed to avoid excessive treatment.

This study aimed to sequence and annotate the complete mitochondrial DNA genome sequence of Opsarius pulchellus. Complete mitochondrial genome is a circular molecule of 16,552 bp in length, including 13 protein-coding genes (PCGs), 22 tRNA genes, two rRNA genes, and a displacement loop region. Proportion of nucleotides in mitochondrial genome is 26.8% T, 26.9% C, 27.6% A, and 18.8% G, with an AT bias of 54.4%. Maximum-likelihood phylogenetic tree was reconstructed using the connected protein sequences of 13 PCGs of O. pulchellus and other 18 fishes. Result of phylogenetic analysis supports a close relationship between O. pulchellus and Barilius bendelisis (Hamilton, 1807). Fundamental genetic data of O. pulchellus would be beneficial for further studies on genetic diversity and phylogeny.

BackgroundThe present meta-analysis was to explore the surgical and oncological outcomes of bursectomy for advanced gastric cancer (AGC).MethodsRelevant studies that evaluated the role of bursectomy for AGC were comprehensively examined to perform a meta-analysis. The primary outcomes were overall survival (OS) and disease-free survival (DFS). The secondary outcomes were the number of harvested lymph nodes (LNs), operation time, operative bleeding, hospital stay, postoperative complication and mortality.ResultsA total of seven studies comprising 2633 cases (1176 cases in the bursectomy group and 1457 cases in the non-bursectomy group) were finally included. There was no significant difference in OS (HR 0.95, P = 0.647) and DFS (HR 0.99, P = 0.936) between the two groups. Even for patients with serosa-penetrating tumours, OS was comparable between the two groups (HR 0.87, P = 0.356). The operation time of the bursectomy group was longer (weighted mean difference, WMD 32.76 min, P = 0.002). No significant difference was found between the two groups in terms of the number of dissected LNs (WMD 5.86, P = 0.157), operative bleeding (WMD 66.99 ml, P = 0.192) and hospital stay (WMD − 0.15 days, P = 0.766). The overall postoperative complication (relative risk, RR 1.08, P = 0.421) and mortality (RR 0.44, P = 0.195) were similar between two groups.ConclusionsThis meta-analysis indicated that bursectomy is time-consuming without increasing the number of harvested LNs. Although bursectomy can be safely performed without increasing complications and mortality, it does not prolong the OS and DFS of AGC patients, including patients with serosa-penetrating tumours. Therefore, bursectomy should not be recommended as a standard procedure for AGC.Electronic supplementary materialThe online version of this article (10.1186/s12957-018-1354-1) contains supplementary material, which is available to authorized users.