Background: The emergence of robotic surgical systems compensated for the technological shortcomings of laparoscopic approaches. However, whether robotic gastrectomy (RG) has better perioperative outcomes and survival than laparoscopic gastrectomy (LG) for gastric cancer (GC) is still unclear but increasingly drawing attention. Materials and methods: In this systematic review and meta-analysis, we searched PubMed, EMBASE, Web of Science, and Cochrane Library as of 20 January 2024, and referenced a list of eligible articles for all published studies comparing RG and LG for patients with GC. Data on study characteristics, individual characteristics, and outcome parameters were extracted. The quality of studies was assessed using the Revised Cochrane risk-of-bias 2 tool and the risk of bias in nonrandomized studies of interventions tool. The main outcome measures were overall survival (OS) and disease-free survival (DFS). Results: The authors identified 3641 articles, of which 72 studies (30 081 patients) were included in the meta-analysis. Compared with LG, RG was associated with higher OS [hazard ratio (HR)=0.89, 95% CI=0.83–0.96], lower rate of overall postoperative complications [odds ratio (OR)=0.77, 95% CI=0.71–0.84], longer operating time [mean difference (MD)=35.53, 95% CI=29.23–41.83], less estimated blood loss (MD=−37.45, 95% CI=−46.24 to −28.67), a higher number of retrieved lymph nodes (MD=1.88, 95% CI=0.77–3.00), faster postoperative recovery, and lower rate of conversion (OR=0.44, 95% CI=0.36–0.55). Mortality and DFS were not significantly different between the two groups. The subgroup of meta-analysis results also showed the advantages of robotic surgery over laparoscopic surgery in intracorporeal reconstruction, total gastrectomy, Ⅰ/Ⅱ stage, and BMI≥25, especially for patients with stage Ⅰ/Ⅱ, there are better OS and DFS. Conclusion: Our findings point to robotic surgery having great benefits compared with laparoscopic surgery in GC. Our study may help inform decision-making in applying robotic surgical systems to clinical treatment.

Esophageal squamous cell carcinoma (ESCC) is one of leading malignant cancers of gastrointestinal tract worldwide. Until now, the involved mechanisms during the development of ESCC are largely unknown. This study aims to explore the driven-genes and biological pathways in ESCC. mRNA expression datasets of GSE29001, GSE20347, GSE100942, and GSE38129, containing 63 pairs of ESCC and non-tumor tissues data, were integrated and deeply analyzed. The bioinformatics approaches include identification of differentially expressed genes (DEGs) and hub genes, gene ontology (GO) terms analysis and biological pathway enrichment analysis, construction and analysis of protein–protein interaction (PPI) network, and miRNA–gene network construction. Subsequently, GEPIA2 database and qPCR assay were utilized to validate the expression of hub genes. DGIdb database was performed to search the candidate drugs for ESCC. Finally, 120 upregulated and 26 downregulated DEGs were identified. The functional enrichment of DEGs in ESCC were mainly correlated with cell cycle, DNA replication, deleted in colorectal cancer (DCC) mediated attractive signaling pathway, and Netrin-1 signaling pathway. The PPI network was constructed using STRING software with 146 nodes and 2392 edges. The most significant three modules in PPI were filtered and analyzed. Totally ten genes were selected and considered as the hub genes and nuclear division cycle 80 (NDC80) was closely related to the survival of ESCC patients. DGIdb database predicted 33 small molecules as the possible drugs for treating ESCC. In summary, the data may provide new insights into ESCC pathogenesis and treatments. The candidate drugs may improve the efficiency of personalized therapy in future.

Background: We conducted a systematic review and meta-analysis to summarize the predictive and prognostic ability of the log odds of positive lymph nodes (LODDS) staging system and compare it with pathological N (pN) classification and the ratio-based lymph node system (rN) for the overall survival (OS) of gastric cancer (GC). Methods: Through a systematic review till March 7, 2022, we identified population-based studies that reported the prognostic effects of LODDS in patients with GC. We compare the predictive effectiveness of the LODDS staging system with that of the rN and pN classification systems for the OS of GC. Results: Twelve studies comprising 20,312 patients were included in this systematic review and meta-analysis. The results showed that LODDS1, LODDS2, LODDS3, and LODDS4 in GC patients were correlated with poor OS compared with LODDS0 (LODDS1 vs. LODDS0: HR = 1.62, 95% CI (1.42, 1.85); LODDS2 vs. LODDS0: HR = 2.47, 95% CI (2.02, 3.03); LODDS3 vs. LODDS0: HR = 3.15, 95% CI (2.50, 3.97); LODDS4 vs. LODDS0: HR = 4.55, 95% CI (3.29, 6.29)). Additionally, significant differences in survival were observed among patients with different LODDS classifications (all P-values were < 0.001) with the same rN and pN classifications. Meanwhile, for patients with different pN or rN classifications with the same LODDS classification, prognosis was highly similar. Conclusion: The findings show that LODDS is correlated with the prognosis of GC patients and is superior to the pN and rN classifications for prognostic assessment.

Acetaminophen (APAP)-induced liver injury (AILI) has an increasing incidence worldwide. However, the mechanisms contributing to such liver injury are largely unknown and no targeted therapy is currently available.

Background: Gastric cancer (GC) is a common highly recurrent malignant tumor that is associated with poor prognosis. Circulating tumor cells (CTCs) have drawn much attention because of their diagnostic value in diverse cancers, including GC. This study aimed to assess the relevance of CTCs in predicting the clinicopathological parameters and prognostic significance of GC. Methods: We systematically searched PubMed, Medline and Web of Science for relevant studies. Each database was searched from its date of inception through January 22, 2020. The odds ratios (ORs), hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated as effect values using the random-effects model. Results: In total, 52 articles that reported 68 studies comprising 4158 GC patients were included. The pooled results on TNM stage indicated that the III/IV group had a notably higher CTCs positivity rate than the I/II group (OR=2.73, 95% CI (1.95,3.82), I²=65%). The poorly differentiated group had a significantly higher CTCs positivity rate than the well/moderately differentiated group (overall: OR=1.91, 95% CI (0.77,4.71)), as well as the Lauren classification diffuse/hybrid type group and the intestinal group (overall: OR=1.77, 95% CI (0.70,4.44)). The bulk of analysis revealed that CTC positivity detected in GC patients was correlated with worse overall survival (OS) (HR =1.94, 95% CI (1.64,2.30), P≤0.001), progression-free survival (PFS) (HR =2.45, 95% CI (1.65,3.64), P≤0.001), and disease-free survival (DFS) (HR =2.78, 95% CI (1.89,4.10), P≤0.001). Then, we extracted data and analyzed the DCR of chemotherapy in patients with GC, and the pooled analysis demonstrated that the DCR of the CTC positivity was lower than that of the CTC negativity (RR =0.63, 95% CI (0.44,0.91))Conclusions: In conclusion, our study demonstrated that the CTCs positivity was correlated with the poor OS, PFS and DFS in GC patients and provided a scientific foundation for gastric cancer staging.