Background:Previous studies have revealed that the number of cancer survivors developing a second primary malignancy is increasing, especially among thyroid cancer patients, and lung cancer is still the main cause of cancer death. Therefore, we aimed to investigate the risk of second primary lung cancer (SPLC) in patients with thyroid cancer.Methods:We searched the PubMed, Web of Science, Embase, and Scopus databases up to November 24, 2021, for relevant research and merged the standardized incidence ratios (SIRs) and 95% confidence intervals (95% CIs) to evaluate the risk of developing SPLC in patients with thyroid cancer.Results:Fourteen studies involving 1,480,816 cases were included in our meta-analysis. The pooled result demonstrated that thyroid cancer patients may have a higher risk of SPLC than the general population (SIR = 1.21, 95% CI: 1.07-1.36, P < 0.01, I-2 = 81%, P < 0.01). Subgroup analysis stratified by sex indicated that female patients may have a markedly higher risk of SPLC than male patients (SIR = 1.65, 95% CI: 1.40-1.94, P < 0.01, I-2 = 75%, P < 0.01).Conclusions:Thyroid cancer patients are more likely to develop SPLC than the general population, especially women. However, other risk factors must be investigated, and more prospective studies are needed to confirm our results.Registration:International Prospective Register of Systematic Reviews: No. CRD42021285399.

The prognosis and safety of continuous saline bladder irrigation (CSBI) after transurethral resection of bladder tumor (TURB) as an alternative method needs to be explored. A literature review and meta-analysis were performed by searching PubMed, EMBASE, Cochrane Library databases and original references of the included articles. PRISMA checklists were followed. We used the GRADEpro GDT to assess the certainty of evidence from the results of our meta-analysis. A total of eight articles including 1600 patients were studied. The results indicated that patients received CSBI after TURB had no statistical differences compared to the control group in the recurrence-free survival and progression-free survival. However, the CSBI group showed significant improvements compared to the control group in terms of the number of recurrences during follow-up and the period to first recurrence except for the number of tumor progression during follow-up. Furthermore, patients treated with CSBI did not show an inferior effect than those treated with immediate intravesical chemotherapy (IC) in respects of recurrence-free survival, progression-free survival, the number of recurrences during follow-up, the number of tumor progression during follow-up and the period to first recurrence. But the immediate IC group had a higher incidence than the CSBI group in terms of macrohematuria, micturition pain, frequency of urination, dysuria, retention and local toxicities. Patients treated with CSBI after TURB showed a significant improvement compared to the control group in terms of the number of recurrences during follow-up and the period to first recurrence. However, compared to immediate IC, CSBI did not show an inferior effect except for lower incidence of adverse reactions.PROSPERO registration number CRD42021247088.

The effects of different intensities of evening exercise on subsequent sleep remain contradictory. Thus, this systematic review and network meta-analysis aimed to compare and rank the effects of different intensities of acute evening exercise on sleep in healthy adults with good sleep. Articles were systematically searched journals indexed in the PubMed, Web of Science, Cochrane Library, Embase, and Scopus databases from inception to the 5th of May, 2022. The basic search terms included exercise, sleep and timing, which were combined with AND. Of the 12,203 retrieved, twenty-eight studies with 325 participants met the inclusion criteria. Results revealed that there were no significant differences in terms of impacts on sleep caused by different intensities of acute evening exercise, except that when compared to no exercise, acute evening high-intensity exercise decreased rapid eye movement sleep (mean difference [MD] = -1.95%, 95% credible interval [CI] = -3.58 to -0.35). Compared to no exercise, acute evening moderate-intensity exercise was ranked as the most potential method to improve sleep, displaying a trend to improve wake time after sleep onset (MD = -2.50 min, 95% CI = -8.17 to 1.62), sleep efficiency (MD = +0.41%, 95% CI = -0.71 to 1.66), the proportion of stage N1 (MD = -0.72%, 95% CI = -2.08 to 0.71) and N3 sleep (slow-wave sleep) (MD = +0.84%, 95% CI = -1.17 to 2.78). Acute evening low-intensity exercise displayed the greatest tendency to shorten sleep onset latency (MD = -1.02 min, 95% CI = -4.39 to 2.50) compared to no exercise. Overall, regardless of intensity, acute evening exercise completed before bedtime does not disrupt subsequent sleep in healthy young and middle-aged adults.

Parkinson’s disease (PD) represents the second most common neurodegenerative disease. To evaluate the effects of dance therapy (DT) aimed at improving non-motor symptoms in PD. Studies were performed through PubMed, Web of Science, The Cochrane Library, Embase, and Science Direct from inception to October 27, 2021. The data were screened independently by two reviewers, and the quality of the papers was assessed using the Cochrane manual. The included studies were randomized controlled trials and quasi-randomized controlled trials, reporting random-effects standardized mean differences, and 95% confidence intervals as the effect size. I2 statistics were used to assess heterogeneity. The main outcomes included the Montreal Cognitive Assessment Scale (MOCA), Baker Depression Scale (BDI), Parkinson’s Fatigue Scale (FPS-16), and Apathy Scale (AS). RevMan 5.3 software was integrated for meta-analysis. Nine literatures were analyzed for the meta-analysis with a total of 307 patients. Random effects showed that DT significantly improved cognitive of PD (MD = 1.50, 95% CI [0.52, 2.48], P = 0.0003; I2 = 51%). However, this meta-analysis demonstrated that dance therapy had no significance for improving depression (MD = − 1.33, 95% CI [− 4.11, 1.45], P = 0.35; I2 = 79%), fatigue (MD = 0.26, 95% CI [− 0.31, 0.83], P = 0.37; I2 = 0%), and apathy (MD = 0.07, 95% CI [− 2.55, 2.69], P = 0.96; I2 = 50%). The meta-analysis suggests that dance can improve cognitive function in PD.

Background Studies have shown that high-intensity interval training (HIIT) is superior to moderate-intensity continuous training (MICT) for increasing peak oxygen uptake (VO2peak) and reducing cardiovascular disease (CVD) and mortality. To our knowledge, previously published systematic reviews have neither compared different HIIT models with MICT nor investigated intervention frequencies of HIIT vs. MICT for purposes of improving cardiorespiratory fitness in patients with CVD. Objective The purpose of this meta-analysis was to compare the effects of different training models, intervention frequencies and weeks of HIIT vs. MICT on changes in cardiorespiratory fitness during cardiac rehabilitation (CR). Methods A systematic search was carried out for research articles on randomized controlled trials (RCTs) indexed in the PubMed, Cochrane Library, Web of Science, Embase and Scopus databases for the period up to December 2021. We searched for RCTs that compared the effect of HIIT vs. MICT on cardiorespiratory fitness in patients with CVD. Results Twenty-two studies with 949 participants (HIIT: 476, MICT: 473) met the inclusion criteria. Sensitivity analysis revealed that HIIT increased VO2peak more than MICT (MD = 1.35). In the training models and durations, there was a greater increase in VO2peak with medium-interval HIIT (MD = 4.02) and more than 12 weeks duration (MD = 2.35) than with MICT. There were significant improvements in VO2peak with a HIIT frequency of 3 times/week (MD = 1.28). Overall, one minor cardiovascular and four non-cardiovascular adverse events were reported in the HIIT group, while six non-cardiovascular adverse events were reported in the MICT group. Conclusion HIIT is safe and appears to be more effective than MICT for improving cardiorespiratory fitness in patients with CVD. Medium-interval HIIT 3 times/week for more than 12 weeks resulted in the largest improvement in cardiorespiratory fitness during CR. Systematic Review Registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021245810, identifier: CRD42021245810.

PurposeThe aim of the study was to comprehensively understand the combined hepatocellular and cholangiocarcinoma (CHC) and develop a nomogram for prognostic prediction of CHC.MethodsData were collected from the Surveillance, Epidemiology and End Results (SEER) database (year 2004–2014). Propensity-score matching (PSM) was used to match the demographic characteristic of the CHC versus hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC). A nomogram model was established to predict the prognosis in terms of cancer specific survival (CSS). The established nomogram was externally validated by a multicenter cohort.ResultsA total of 71,756 patients enrolled in our study including 62,877 HCC patients, 566 CHC patients, and 8303 ICC patients. The CHC, HCC, and ICC are not exactly similar in clinical characteristic. After PSM, the CSS of CHC was better than HCC but comparable to ICC. Tumor size, M stage, surgery, chemotherapy, and surgery were independently prognostic factors of CHC and were included in the establishment of novel nomogram.The c-index of the novel nomogram in SEER training set and multicenter validation was 0.779 and 0.780, respectively, which indicated that the model was with better discrimination power. In addition, decision curve analyses proved the favorable potential clinical effect of the predictive model. Lastly, a risk classification based on nomogram also verified the reliability of the model.ConclusionCHC had better survival than HCC but was comparable to ICC. The nomogram was established based on tumor size, M stage, chemotherapy, surgery, and radiotherapy and well validated by external multicenter cohort.

Abstract Sarcopenia is a progressive skeletal muscle disorder involving the loss of muscle mass and function, associated with an increased risk of disability and frailty. Though its prevalence in dementia has been studied, its occurrence in mild cognitive impairment (MCI) has not been well established. As MCI is often a prelude to dementia, our study aims to investigate the prevalence of MCI among individuals with sarcopenia and to also ascertain whether sarcopenia is independently associated with MCI. The Cochrane Library, PubMed, Ovid, Embase and Web of Science were systematically searched for articles on MCI and/or sarcopenia published from inception to 1 February 2022. We reviewed the available literature on the number of individuals with MCI and/or sarcopenia and calculated odds ratios (ORs) of sarcopenia in MCI and MCI in sarcopenia, respectively. Statistical analyses were performed using the meta package in Stata, Version 12.0. A total of 13 studies and 27 428 patients were included in our analysis. The pooled prevalence of MCI in participants with sarcopenia was 20.5% (95% confidence interval [CI]: 0.140–0.269) in a total sample of 2923 cases with a high level of heterogeneity (P < 0.001; I2 = 95.4%). The overall prevalence of sarcopenia with MCI was 9.1% (95% CI: 0.047–0.134, P < 0.001; I2 = 93.0%). For overall ORs, there were 23 364 subjects with a mean age of 73 years; the overall adjusted OR between MCI and sarcopenia was 1.46 (95% CI: 1.31–1.62). Slight heterogeneity in both adjusted ORs (P = 0.46; I2 = 0%) was noted across the studies. The prevalence of MCI is relatively high in patients with sarcopenia, and sarcopenia may be a risk factor for MCI.

Objective: This study aimed to assess the efficacy and safety of hepatic arterial infusion chemotherapy (HAIC) with modified FOLFOX (5fluorouracil, leucovorin, and oxaliplatin) as an alternative treatment option in advanced hepatocellular carcinoma (HCC) patients with failed or unsuitability for transarterial chemoembolization (TACE). Materials and Methods: From September 2018 to January 2020, 87 advanced HCC patients who progressed on TACE or were not eligible for TACE received HAIC treatment with modified FOLFOX. The primary endpoint was overall survival (OS) and secondary endpoints included progression-free survival (PFS), tumor response assessed by Response Evaluation Criteria in Solid Tumors 1.1, and adverse events graded according to CTCAE 5.0. Based on prognostic factors determined by multivariate analysis, a nomogram was developed to predict patient survival. Results: The median OS and PFS were 9.0 months (95%CI 7.6-10.4) and 3.7 months (95%CI 3.1-4.3), respectively. The objective response rate was 13.8%, with a disease control rate of 48.3%. Grade 3 adverse events were observed, such as infection (9.2%), thrombocytopenia (5.7%), hyperbilirubinemia (3.4%), abdominal pain (2.3%) and alanine aminotransferase increase (2.3%). Albumin, AST, and extrahepatic metastasis were incorporated to construct a new nomogram that could stratify patients into three prognostic subgroups, including low-, intermediate-, and high-risk groups, with significant differences in 9-month OS rates (71%, 42% and 6%, respectively; p< 0.001). The nomogram was better than the Okuda, AJCC, and CLIP staging systems for OS prediction. Conclusion: These findings support the feasibility of HAIC with modified FOLFOX as an alternative treatment strategy for advanced HCC when TACE is ineffective or unsuitable.

Background: Prostatic leiomyosarcoma (LMS) has a poor prognosis with a median overall survival (OS) of 15–18 months. For patients with metastatic disease, radical surgical resection, with or without adjuvant systemic chemotherapy and radiation therapy, unfortunately provides limited therapeutic benefit. Novel approaches for this lethal disease are urgently needed. Objectives: To evaluate the feasibility and efficacy of transarterial chemoembolization (TACE) with doxorubicin-eluting HepaSpheres (HS) for inoperable LMS of the prostate. Methods: This case series included 12 patients (median age 57 years, range 32–74) with inoperable LMS of the prostate who were treated with TACE using doxorubicin-eluting HS. All patients were pathologically proved by fine-needle biopsy. Symptomatic relief, complications, OS, and local disease control based on modified Response Evaluation Criteria in Solid Tumors (mRECIST) criteria were evaluated. Results: Symptomatic relief, including control of the gross hematuria, removal of indwelling catheters, improvement of constipation and perineal pain, were obtained in 100%, 75%, 100%, and 86%, respectively after TACE, without any major complications. At the last follow-up after TACE, the percentage of the tumor necrosis and volume reduction were present with a median value of 90% and 84%, respectively. TACE after two to four sessions allowed subsequent surgical resection in five (41.7%) patients. The median follow-up time was 29 months; the survival rate at 1, 2, and 3 years was 91.7%, 83.3%, and 41.7%, respectively, and the median OS was 29 months (range 9–49 months). Conclusions: TACE of inoperable LMS of the prostate appears to be safe and effective in providing tumor necrosis, shrinkage, and symptom relief; that could improve the quality of life and the survival rate of these patients.

BACKGROUND:Exercise training is beneficial for cardiac rehabilitation. Nevertheless, few study focused on the role of high-intensity interval training (HIIT) in cardiac repair. The current study aimed to elucidate the effect of HIIT on cardiac rehabilitation and the involved mechanisms after acute myocardial infarction (MI). METHODS:A total of 65 male rats underwent coronary ligation or sham operation and were randomly assigned to 4 groups: sham (n = 10), sedentary (MI-Sed, n = 12), moderate-intensity continuous training (MI-MCT, n = 12) and HIIT (MI-HIIT, n = 12). One week after MI induction, adaptive training starts follow by formal training. After the experiment, cardiac functions were determined by echocardiography and hemodynamic measurements. Changes in infarct size, collagen accumulation, myofibroblasts, angiogenesis, inflammation level, endothelin-1 (ET-1), and renin-angiotensin-aldosterone system (RAAS) activities were measured. Data were analyzed by one-way ANOVA. RESULTS:After MI, cardiac structure and function were significantly deteriorated. However, post-MI HIIT for 8 weeks had significantly ameliorated left ventricular end-diastolic pressure (LVEDP), LV systolic pressure (LVSP), and maximum peak velocities of relaxation (-dP/dtmax). Moreover, it preserved cardiac functions, reduced infarct size, protected the myocardium structure, increased angiogenesis and decreased the myofibroblasts and collagen accumulation. HIIT for 4 weeks had no effect on LVEDP, -dP/dtmax, infarct size and angiogenesis. Additionally, it induced inflammation response and repressed ET-1 and RAAS activities were found in myocardium and peripheral circulation after HIIT. CONCLUSION:Our results suggested that post-MI HIIT had a positive role in cardiac repair, which might be linked with the induction of inflammation and inhibition of ET-1 and RAAS activities.

Background/Aim: Cetuximab in combination with chemotherapy is recommended as first-line therapy for metastatic colorectal cancer (mCRC) with wild-type RAS. However, drug resistance to cetuximab exists widely in mCRC and reduces the prognosis of patients. Although some genomic alterations have been demonstrated to drive acquired resistance to cetuximab, the overall compendium of inherent molecular mechanisms is still incomplete. Materials and Methods: Four liver metastasis biopsies were collected from two mCRC patients who were treated with cetuximab in combination with 5-fluororacil plus leucovorin and oxaliplatin (FOLFOX) regimen. Results: Transcriptomic analysis revealed global gene expression alterations between paired samples prior to treatment and after acquired resistance. Further bioinformatics analysis discovered differentially expressed protein-coding genes/lncRNAs/miRNAs, potential miRNA-mRNA regulatory networks and lncRNA-mRNA competing endogenous RNA network, which may be potential biomarkers or play roles during the process of acquired resistance to cetuximab. Conclusion: Our study contributes to deciphering the molecular mechanisms of acquired resistance to cetuximab.

Abstract Purpose: Mutations in KRAS are considered to be the main drivers of acquired resistance to epidermal growth factor receptor (EGFR) blockade in patients with metastatic colorectal cancer (mCRC). However, the potential role of other genes downstream of the EGFR signaling pathway in conferring acquired resistance has not been extensively investigated. Experimental Design: Using circulating tumor DNA (ctDNA) from patients with mCRC and with acquired cetuximab resistance, we developed a targeted amplicon ultra-deep sequencing method to screen for low-abundance somatic mutations in a panel of genes that encode components of the EGFR signaling pathway. Mutations with significantly increased variant frequencies upon disease progression were selected by using quartile analysis. The functional consequences of the identified mutations were validated in cultured cells. Results: We analyzed 32 patients with acquired cetuximab resistance in a development cohort. Of them, seven (22%) carried five novel PIK3CA mutations, whereas eight (25%) carried previously reported KRAS mutations. Functional studies showed that novel PIK3CA mutations (all in exon 19; p.K944N, p.F930S, p.V955G, p.V955I, and p.K966E) promote cell viability in the presence of cetuximab. Only one novel PIK3CA mutation (p.K944N) was verified in one of the 27 patients with acquired resistance in a validation cohort, simultaneous KRAS and PIK3CA hotspot mutations were detected in two patients. Among the above 59 acquired resistance patients, those with PIK3CA or RAS mutations detected in ctDNA showed a pronounced decrease in progression-free survival than patients with no mutation. Conclusions: The PIK3CA mutations may potentially contribute to acquired cetuximab resistance in patients with mCRC. Clin Cancer Res; 23(16); 4602–16. ©2017 AACR.

Background We explore the clinical and prognostic significance of expression of vascular endothelial growth factor receptor (VEGFR)-2, platelet-derived growth factor receptor (PDGFR)-β, and c-Met in patients with hepatocellular carcinoma (HCC). Methods The expression of VEGFR-2, PDGFR-β, and c-Met were determined by immunohistochemical examination of the tissues of 93 HCC patients. The relationships of these markers with clinicopathological factors and prognosis were then analyzed. Results High expression of VEGFR-2, PDGFR-β, and c-Met was found in 86%, 19.4%, and 80.6% of patients, respectively. Expression of VEGFR-2 correlated with gender (P = 0.044), hepatitis B surface antigen positivity (P = 0.024), degree of tumor differentiation (P = 0.023), and hepatic cirrhosis (P = 0.026). Expression of PDGFR-β correlated with alpha-fetoprotein level (P = 0.029), tumor size (P = 0.033), and hepatic cirrhosis (P = 0.023). No significant correlations were identified between expression of c-Met and clinicopathological factors. Expression of PDGFR-β correlated with overall survival (P = 0.046) and expression of c-Met correlated with progression-free survival (P = 0.01). Conclusions We found that in patients with HCC, high expression of VEGFR-2 correlates with chronic hepatitis B virus infection and hepatic cirrhosis. High expression of PDGFR-β is a predictor of poor prognosis. High expression of C-Met may predict therapeutic effectiveness of sorafenib in HCC patients.

Objective To explore the clinical significance and prognostic values of VEGFR-2,PDGFR-β and c-MET in patients with hepatocellular carcinoma(HCC).Methods The expression of VEGFR-2,PDGFR-β and c-MET in 93 HCC patients was examined by immunohistochemistry(IHC),and the correlation between clinical characteristics and progrosis was analyzed.Results The over-expression rates of VEGFR-2,PDGFR-β and c-MET in HCC were 86.0%,19.4% and 80.6%,respectively.The expression of VEGFR-2 was related with sex,hepatitis B surface antigen(HBsAg) status,differentiation and hepatic cirrhosis(P0.05).The expression of PDGFR-β was related with α-fetoprotein(AFP),number of tumor and hepatic cirrhosis(P0.05).There was no significant relationship between the expression of c-MET and clinicopathological factors.Cox regression analysis showed that in 65 patients taking sorafenib,the progress free survival(PFS) was related to age(P=0.047),and the overall survival(OS) was related to HBsAg(P=0.037),AFP(P=0.015) and tumor size(P=0.003).The expression of PDGFR-β was related with OS(P=0.046).The expression of c-MET was related to PFS(P=0.01).Conclusion The expression level of VEGFR-2 is higher in HCC patients with hepatic cirrhosis.PDGFR-β is a biomarker for the poor prognosis in HCC patients.c-MET may be a prognostic factor to predict the therapeutic effect of HCC patients who have taken sorafenib.

OBJECTIVETo evaluate the current clinical treatment status of gastric cancer in China.METHODSA retrospective analysis of clinicopathological characteristics of 636 patients with gastric cancer was conducted. Tumor response was evaluated using RECIST version 1.1 criteria.RESULTSSix hundred and thirty-six patients were included in this retrospective cohort: 479 men and 157 women. The median age was 57 years (14 to 86). The tumor site was: proximal (41.4%), distal (46.4%) or unknown (12.2%). The histology was: adenocarcinoma (85.8%), signet ring cell carcinoma (6.9%), or other and unknown (7.2%). The differentiation of the adenocarcinomas was: well differentiated (31.0%), moderately differentiated (13.4%), poorly differentiated (37.0%), or unknown (18.7%). The pTNM stage was: 0 (0.3%), I (3.6%), II (10.1%), III (36.8%), IV (45.6%), or unknown (3.6%). In 284 patients who underwent radical resection, the ratio of examined ten and/or more lymph nodes was higher in hospitals at or above provincial level than in hospitals at regional level (57.9% vs. 39.6%, P = 0.009). The disease-free survival was longer (21.7 m vs. 14.6 m, P = 0.005), and the overall survival was longer too (52.9 m vs. 33.8 m, P = 0.040). In 205 patients who received adjuvant chemotherapy, the ratio of administered six and/or more cycles chemotherapy was 42.1% vs. 35.2% (P = 0.318), and the disease-free survival was 22.7 m vs. 16.3 m (P = 0.005) between hospitals at or above provincial level and hospitals at regional level. In 387 patients with metastatic or unresectable gastric cancer who received palliative chemotherapy, the overall survival was 11.1 m (95%CI 9.9 - 12.3 m). Among them, 198 patients received second and/or more line chemotherapy, and the overall survival was longer (12.5 m vs. 7.7 m, P < 0.001). Except a longer progression-free survival (10.2 m, P < 0.05) and a longer overall survival (16.9 m, P < 0.05) were corresponded with the regimen containing trastuzumab, no other significant difference was observed among regimens in first line chemotherapy.CONCLUSIONChinese doctors working in different level hospitals have a different understanding of the treatment standard of gastric cancer, which resulted in different outcomes.

OBJECTIVE:To assess the HER-2 status in Chinese advanced gastric cancer patients and explore its correlation with clinical features, treatment response and prognosis.METHODS:A total of 107 patients with advanced gastric cancer treated in our hospital from December 2005 to November 2008 were included in this retrospective analysis. HER-2 status was determined by immunohistochemisty (IHC) and/or fluorescence in situ hybridization (FISH). The correlations of HER-2 status with tumor location, pathology, treatment response and prognosis were analyzed and the efficacy of different chemottherapy regimens was compared.RESULTS:The overall positive rate of HER-2 expression was 14.7% (15/102). The HER-2 status was detected by both methods in 102 patients, and the concordance of the two methods was 66.5%. The tumor site distribution was gastroesophageal junction (GEJ) 28.0%, proximal stomach 19.4%, gastric corpus 16.1%, antrum 26.9% and whole stomach 9.7%, respectively. There was no significant difference of HER-2 status among different tumor sites (P = 0.726), and no significant correlation between HER-2 expression and differentiation (P = 0.110). Among the evaluable 51 patients treated by first-line chemotherapy, the total objective effective rate was 23.5%. The median time-to-progression was 7.47 months, and median overall survival time was 11.07 months. The effective rate was 43.8% in patients who received XP regimen chemotherapy (cisplatin + capecitabine), significantly higher than the 14.3% in patients treated with other regimens (P = 0.033). Their overall survival was 14.17 months and 9.53 months, respectively (P = 0.059). The TTP was 6.63 months in HER-2 positive patients and 7.47 months in HER-2 negative patients, with a non-significant difference (P = 0.510). However, there was a improving tendency in the efficacy and OS, showing a effective rate of 45.5% and 17.5% (P = 0.102) and OS of 14.17 months and 10.63 months, respectively (P = 0.205).CONCLUSIONS:HER-2-positivity rate in Chinese patients with advanced gastric cancer is similar to those reported in the literature. Along with the increasing use of targeted therapy and targeted agents, the efficacy and survival of gastric cancer patients is improving. HER-2-positive patients may benefit from it.