Gastric cancer(GC)remains a leading cause of cancer mortality.While the extent of nodal involvement is a well-known prognostic factor,the specific entity of swollen lymph node metastasis(SLNM),bulky nodal tumor deposi...Gastric cancer(GC)remains a leading cause of cancer mortality.While the extent of nodal involvement is a well-known prognostic factor,the specific entity of swollen lymph node metastasis(SLNM),bulky nodal tumor deposits detectable radiologically or pathologically,has received little attention in staging.Recent data from a study by Cui et al demonstrated that SLNM is an independent predictor of very poor survival in GC.Through robust data and rigorous propensitymatched analyses,SLNM emerged not merely as an anatomical finding but as an independent predictor of poor prognosis,even among patients undergoing curative resection.As precision oncology advances,the findings by Cui et al urge a fundamental rethinking of how SLNM is incorporated into clinical decisionmaking for GC management.In this editorial,we critically examine the prognostic significance of SLNM,challenge its omission from traditional staging frameworks,and advocate for its formal integration into preoperative risk stratification and treatment planning.Recognizing SLNM at diagnosis could unlock intensified neoadjuvant therapy strategies and optimize outcomes for a historically high-risk patient subgroup.展开更多
Gastric carcinoma is a leading cause of cancer-related mortality worldwide,yet reliable noninvasive biomarkers for its early detection remain limited.As research continues to elucidate the inflammatory underpinnings o...Gastric carcinoma is a leading cause of cancer-related mortality worldwide,yet reliable noninvasive biomarkers for its early detection remain limited.As research continues to elucidate the inflammatory underpinnings of tumor initiation and progression,it has become increasingly clear that pro-inflammatory cytokines may hold promise as diagnostic adjuncts.Serum cytokines such as interleukin(IL)-1β,IL-6,IL-8,and interferon-gamma have been frequently reported as elevated in gastric cancer patients compared to healthy individuals.These molecules,known for their roles in modulating tumor-promoting inflammation,angiogenesis,and immune evasion,may serve as accessible indicators of disease presence or progression.Several studies have shown that individual cytokines,particularly IL-6 and IL-8,can achieve receiver operating characteristic curves and area under the curve values exceeding 0.70,suggesting reasonable diagnostic utility.We assess the comparative utility of individual cytokines versus multiplex panels,evaluate their roles in tumor biology and treatment resistance,and situate these findings within the broader inflammatory biomarker landscape.Limitations of the current literature,including small sample sizes,heterogeneity in study design,and lack of specificity,are critically discussed.We advocate for prospective,multicenter validation studies and highlight the promise of integrating inflammatory cytokine profiling into diagnostic algorithms.Composite cytokine panels may better reflect the complex immunobiology of tumor progression and offer a scalable,accessible adjunct to current gastric cancer screening strategies.展开更多
文摘Gastric cancer(GC)remains a leading cause of cancer mortality.While the extent of nodal involvement is a well-known prognostic factor,the specific entity of swollen lymph node metastasis(SLNM),bulky nodal tumor deposits detectable radiologically or pathologically,has received little attention in staging.Recent data from a study by Cui et al demonstrated that SLNM is an independent predictor of very poor survival in GC.Through robust data and rigorous propensitymatched analyses,SLNM emerged not merely as an anatomical finding but as an independent predictor of poor prognosis,even among patients undergoing curative resection.As precision oncology advances,the findings by Cui et al urge a fundamental rethinking of how SLNM is incorporated into clinical decisionmaking for GC management.In this editorial,we critically examine the prognostic significance of SLNM,challenge its omission from traditional staging frameworks,and advocate for its formal integration into preoperative risk stratification and treatment planning.Recognizing SLNM at diagnosis could unlock intensified neoadjuvant therapy strategies and optimize outcomes for a historically high-risk patient subgroup.
文摘Gastric carcinoma is a leading cause of cancer-related mortality worldwide,yet reliable noninvasive biomarkers for its early detection remain limited.As research continues to elucidate the inflammatory underpinnings of tumor initiation and progression,it has become increasingly clear that pro-inflammatory cytokines may hold promise as diagnostic adjuncts.Serum cytokines such as interleukin(IL)-1β,IL-6,IL-8,and interferon-gamma have been frequently reported as elevated in gastric cancer patients compared to healthy individuals.These molecules,known for their roles in modulating tumor-promoting inflammation,angiogenesis,and immune evasion,may serve as accessible indicators of disease presence or progression.Several studies have shown that individual cytokines,particularly IL-6 and IL-8,can achieve receiver operating characteristic curves and area under the curve values exceeding 0.70,suggesting reasonable diagnostic utility.We assess the comparative utility of individual cytokines versus multiplex panels,evaluate their roles in tumor biology and treatment resistance,and situate these findings within the broader inflammatory biomarker landscape.Limitations of the current literature,including small sample sizes,heterogeneity in study design,and lack of specificity,are critically discussed.We advocate for prospective,multicenter validation studies and highlight the promise of integrating inflammatory cytokine profiling into diagnostic algorithms.Composite cytokine panels may better reflect the complex immunobiology of tumor progression and offer a scalable,accessible adjunct to current gastric cancer screening strategies.
