1.Effect and mechanism of Xihuang Pills on rats with precancerous lesions of breast.
Yong-Jia ZHANG ; Pan-Wen HUANG ; Yong-Tai ZHANG ; Zhi WANG ; Nian-Ping FENG
China Journal of Chinese Materia Medica 2023;48(13):3546-3555
The purpose of this study was to explore the effect and mechanism of Xihuang Pills on rats with precancerous lesions of the breast. Of 48 healthy female rats, 8 were randomly selected as blank group, and the other 40 were treated with 7,12-dimethylbenzanthracene(DMBA) combined with estrogen and progestin to establish a model of precancerous lesions of the breast. The successfully modeled rats were randomly divided into a model group, a tamoxifen group(1.8 mg·kg~(-1)·d~(-1)), a Xihuang Pills low-dose group(0.3 g·kg~(-1)·d~(-1)), a medium-dose group(0.6 g·kg~(-1)·d~(-1)) and a high-dose group(1.2 g·kg~(-1)·d~(-1)). After 30 days of admi-nistration, the histopathological changes of viscera and breast were observed by haematoxylin and eosin(HE) staining, and the visceral index was calculated. Enzyme linked immunosorbent assay(ELISA) was used to detect the contents of estradiol(E_2) and progesterone(P) in serum. The protein expressions of vascular endothelial growth factor(VEGF) and fibroblast growth factor 2(FGF2) were detected by immunohistochemistry. The protein expressions of VEGF, vascular endothelial growth factor receptor 2(VEGFR2), phosphorylated-vascular endothelial growth factor receptor 2(p-VEGFR2), B-cell lymphoma-2(Bcl-2), and Bcl-2 associated X protein(Bax) were detected by Western blot and the mRNA expressions of VEGF, FGF2, CXC-chemokine receptor 4(CXCR4), cysteine aspartic acid-specific protease(caspase-3), and stromal cell-derived factor 1(SDF-1) were detected by real-time polymerase chain reaction(RT-PCR). HE staining revealed that the model group had some liver and kidney damages and severe hyperplastic mammary tissue, while the Xihuang Pills high-dose group had mild hyperplasia. Compared with the model group, the Xihuang Pills groups had lo-wer ovarian coefficient(P<0.05 or P<0.01) and Xihuang Pills high-dose group had lower uterine coefficient(P<0.01). ELISA results showed that compared with the model group, expressions of E_2 and P in Xihuang Pills high-dose group were significantly decreased(P<0.05 or P<0.01). Immunohistochemistry, Western blot and RT-PCR indicated that compared with the conditions in the model group, the protein and mRNA expressions of VEGF and FGF2 in the Xihuang Pills groups were down-regulated(P<0.05 or P<0.01), and the protein expression of Bcl-2 was lowered(P<0.01); there was a decrease in the protein expressions of VEGFR2 and p-VEGFR2(P<0.01), a down-regulation in the mRNA expressions of CXCR4 and SDF-1(P<0.01), while an increase in the mRNA expression of caspase-3(P<0.01) in both Xihuang Pills medium-dose and high-dose groups; the protein expression of Bax in Xihuang Pills high-dose group was increased(P<0.01). The above results indicated that Xihuang Pills can effectively intervene in precance-rous lesions of the breast, and the mechanism may be related to the regulation of E_2 and P secretion as well as the inhibition of angiogenesis and chemokine receptor expression, thus controlling the occurrence of precancerous lesions of the breast in rats.
Rats
;
Female
;
Animals
;
Rats, Sprague-Dawley
;
bcl-2-Associated X Protein
;
Vascular Endothelial Growth Factor A/metabolism*
;
Caspase 3
;
Vascular Endothelial Growth Factor Receptor-2
;
Fibroblast Growth Factor 2
;
Proto-Oncogene Proteins c-bcl-2
;
9,10-Dimethyl-1,2-benzanthracene/toxicity*
;
Precancerous Conditions
;
Hyperplasia
;
Receptors, Chemokine
;
RNA, Messenger
2.Research Progress of Fibroblast Growth Factor Receptor Signaling Pathway in Breast Cancer.
Qiu-Sheng GUO ; Wen-Ming CAO ; Xiao-Jia WANG
Acta Academiae Medicinae Sinicae 2022;44(1):136-141
Breast cancer,one of the common malignant tumors in women,has shown rising incidence in recent years,posing a serious threat to women's health.The advancement of molecular biology facilitates the revealing of the relationships between signaling pathways and breast cancer.Fibroblast growth factor receptor (FGFR) signaling pathway plays an important role in the proliferation,survival,differentiation,migration,and apoptosis of breast cancer cells.Strategies targeting the FGFR signaling pathway thus exhibit a promising prospect in breast cancer treatment.
Apoptosis
;
Breast Neoplasms/metabolism*
;
Female
;
Humans
;
Receptors, Fibroblast Growth Factor/metabolism*
;
Signal Transduction
3.Skeletal mineralization: mechanisms and diseases
Annals of Pediatric Endocrinology & Metabolism 2019;24(4):213-219
Skeletal mineralization is initiated in matrix vesicles (MVs), the small extracellular vesicles derived from osteoblasts and chondrocytes. Calcium and inorganic phosphate (Pi) taken up by MVs form hydroxyapatite crystals, which propagate on collagen fibrils to mineralize the extracellular matrix. Insufficient calcium or phosphate impairs skeletal mineralization. Because active vitamin D is necessary for intestinal calcium absorption, vitamin D deficiency is a significant cause of rickets/osteomalacia. Chronic hypophosphatemia also results in rickets/osteomalacia. Excessive action of fibroblast growth factor 23 (FGF23), a key regulator of Pi metabolism, leads to renal Pi wasting and impairs vitamin D activation. X-linked hypophosphatemic rickets (XLH) is the most common form of hereditary FGF23-related hypophosphatemia, and enhanced FGF receptor (FGFR) signaling in osteocytes may be involved in the pathogenesis of this disease. Increased extracellular Pi triggers signal transduction via FGFR to regulate gene expression, implying a close relationship between Pi metabolism and FGFR. An anti-FGF23 antibody, burosumab, has recently been developed as a new treatment for XLH. In addition to various forms of rickets/osteomalacia, hypophosphatasia (HPP) is characterized by impaired skeletal mineralization. HPP is caused by inactivating mutations in tissue-nonspecific alkaline phosphatase, an enzyme rich in MVs. The recent development of enzyme replacement therapy using bone-targeting recombinant alkaline phosphatase has improved the prognosis, motor function, and quality of life in patients with HPP. This links impaired skeletal mineralization with various conditions, and unraveling its pathogenesis will lead to more precise diagnoses and effective treatments.
Absorption
;
Alkaline Phosphatase
;
Calcium
;
Chondrocytes
;
Collagen
;
Diagnosis
;
Durapatite
;
Enzyme Replacement Therapy
;
Extracellular Matrix
;
Extracellular Vesicles
;
Familial Hypophosphatemic Rickets
;
Fibroblast Growth Factors
;
Gene Expression
;
Humans
;
Hypophosphatasia
;
Hypophosphatemia
;
Metabolism
;
Miners
;
Osteoblasts
;
Osteocytes
;
Prognosis
;
Quality of Life
;
Receptors, Fibroblast Growth Factor
;
Rickets
;
Signal Transduction
;
Vitamin D
;
Vitamin D Deficiency
4.Autophagy Is a Potential Target for Enhancing the Anti-Angiogenic Effect of Mebendazole in Endothelial Cells.
So Jung SUNG ; Hyun Kyung KIM ; Yong Kil HONG ; Young Ae JOE
Biomolecules & Therapeutics 2019;27(1):117-125
Mebendazole (MBZ), a microtubule depolymerizing drug commonly used for the treatment of helminthic infections, has recently been noted as a repositioning candidate for angiogenesis inhibition and cancer therapy. However, the definite anti-angiogenic mechanism of MBZ remains unclear. In this study, we explored the inhibitory mechanism of MBZ in endothelial cells (ECs) and developed a novel strategy to improve its anti-angiogenic therapy. Treatment of ECs with MBZ led to inhibition of EC proliferation in a dose-dependent manner in several culture conditions in the presence of vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF) or FBS, without selectivity of growth factors, although MBZ is known to inhibit VEGF receptor 2 kinase. Furthermore, MBZ inhibited EC migration and tube formation induced by either VEGF or bFGF. However, unexpectedly, treatment of MBZ did not affect FAK and ERK1/2 phosphorylation induced by these factors. Treatment with MBZ induced shrinking of ECs and caused G2-M arrest and apoptosis with an increased Sub-G1 fraction. In addition, increased levels of nuclear fragmentation, p53 expression, and active form of caspase 3 were observed. The marked induction of autophagy by MBZ was also noted. Interestingly, inhibition of autophagy through knocking down of Beclin1 or ATG5/7, or treatment with autophagy inhibitors such as 3-methyladenine and chloroquine resulted in marked enhancement of anti-proliferative and pro-apoptotic effects of MBZ in ECs. Consequently, we suggest that MBZ induces autophagy in ECs and that protective autophagy can be a novel target for enhancing the anti-angiogenic efficacy of MBZ in cancer treatment.
Apoptosis
;
Autophagy*
;
Caspase 3
;
Chloroquine
;
Endothelial Cells*
;
Fibroblast Growth Factor 2
;
Helminths
;
Intercellular Signaling Peptides and Proteins
;
Mebendazole*
;
Microtubules
;
Phosphorylation
;
Phosphotransferases
;
Receptors, Vascular Endothelial Growth Factor
;
Vascular Endothelial Growth Factor A
5.Effect of Ronghuang Granule on serum FGF23, FGFRs and Klotho in non-dialysis patients with CKD-MBD and kidney deficiency and damp-heat syndrome.
Shunjin HU ; Dong WANG ; Rui ZHANG ; Yuanru CAO ; Hua JIN ; Yanping MAO ; Ling WEI ; Kejun REN ; Xuelian ZHANG ; Yiping WANG
Journal of Southern Medical University 2018;38(12):1427-1432
OBJECTIVE:
To observe the effect of Ronghuang granule on serum fibroblast growth factor 23 (FGF23), fibroblast growth factor receptor (FGFRs) and Klotho protein levels in non-dialysis patients with chronic kidney disease-mineral and bone disorder (CKD-MBD) and kidney deficiency and damp heat syndrome.
METHODS:
Seventy non-dialysis CKD-MBD patients with kidney deficiency and dampness-heat syndrome were randomized into control group (=35) and treatment group (=35). All the patients were given routine treatment combined with traditional Chinese medicine retention enema, and the patients in the treatment group received additional Ronghuang granule treatment (3 times a day). After the 12-week treatments, the patients were examined for changes of TCM syndromes. Serum levels of Ca, P, parathyroid hormone (iPTH), FGF23, FGFRs and Klotho proteins were detected before and after treatment. These parameters were also examined in 20 healthy volunteers.
RESULTS:
Sixty-five patients completed the study, including 33 in the control group and 32 in the treatment group. The patients in the treatment group showed significantly better treatment responses than those in the control group ( < 0.05 or 0.01). At 4, 8, and 12 weeks of treatment, the patients in the treatment group had significantly lowered scores of TCM syndromes compared with the score before treatment ( < 0.05 or 0.01), while in the control group, significant reduction of the scores occurred only at 12 weeks ( < 0.05); at each of the time points, the treatment group had significantly greater reductions in the score than the control group ( < 0.01). Significant improvements in serum Ca, P and iPTH levels were observed at 4, 8, and 12 weeks in the treatment group ( < 0.05) but only at 12 weeks in the control group ( < 0.05). The patients in the control and treatment groups all showed elevated serum levels of FGF23, FGFRs and Klotho protein compared with the normal subjects ( < 0.01); FGF23, FGFRs and Klotho levels were significantly reduced in the treatment group ( < 0.05) but remained unchanged in the control group (>0.05), showing significant differences between the two groups.
CONCLUSIONS
Ronghuang granule improves the clinical symptoms of non-dialysis CKD-MBD patients with kidney deficiency and dampness heat syndrome by reducing serum levels of FGF23, FGFRs and Klotho, improving calcium and phosphorus metabolism disorder, and inhibiting secondary hyperparathyroidism.
Calcium
;
blood
;
Chronic Kidney Disease-Mineral and Bone Disorder
;
blood
;
therapy
;
Drugs, Chinese Herbal
;
pharmacology
;
Enema
;
Fibroblast Growth Factors
;
blood
;
Glucuronidase
;
blood
;
Humans
;
Parathyroid Hormone
;
blood
;
Phosphorus
;
blood
;
Receptors, Fibroblast Growth Factor
;
blood
;
Renal Insufficiency, Chronic
;
blood
;
therapy
;
Sweating Sickness
;
blood
;
therapy
;
Syndrome
6.Progress on the Study of Targeting FGFR in Squamous Non-small Cell Lung Cancer.
Ming DONG ; Tong LI ; Jun CHEN
Chinese Journal of Lung Cancer 2018;21(2):116-120
Squamous cell lung cancer (SqCLC) is a unique clinical and histologic category of non-small cell lung cancer (NSCLC). Most of patients with SqCLC tend to be older, typically at advanced stage, associated with smoking and have more complications. With progress of targeted therapy of lung cancer, we identified several potential actionable genetic abnormalities such as FGFR. Several FGFR inhibitors have been approved for clinical use in different cancers. And some of these agents are currently under investigation in clinical trials for SqCLC. This article summarizes the current knowledge about FGFR aberrations, the relative inhibitors in development and clinical data in SqCLC.
Carcinoma, Non-Small-Cell Lung
;
drug therapy
;
genetics
;
metabolism
;
Carcinoma, Squamous Cell
;
drug therapy
;
genetics
;
metabolism
;
Humans
;
Lung Neoplasms
;
drug therapy
;
genetics
;
metabolism
;
Molecular Targeted Therapy
;
methods
;
Mutation
;
Receptors, Fibroblast Growth Factor
;
genetics
;
metabolism
7.Phase II Study of Dovitinib in Patients with Castration-Resistant Prostate Cancer (KCSG-GU11-05).
Yoon Ji CHOI ; Hye Sook KIM ; Se Hoon PARK ; Bong Seog KIM ; Kyoung Ha KIM ; Hyo Jin LEE ; Hong Suk SONG ; Dong Yeop SHIN ; Ha Young LEE ; Hoon Gu KIM ; Kyung Hee LEE ; Jae Lyun LEE ; Kyong Hwa PARK
Cancer Research and Treatment 2018;50(4):1252-1259
PURPOSE: Fibroblast growth factor (FGF) signals are important in carcinogenesis and progression of prostate cancer. Dovitinib is an oral, pan-class inhibitor of vascular endothelial growth factor receptor (VEGFR), platelet-derived growth factor receptor, and fibroblast growth factor receptor (FGFR). We evaluated the efficacy and toxicity of dovitinib in men with metastatic castration resistant prostate cancer (mCRPC). MATERIALS AND METHODS: This study was a single-arm, phase II, open-label, multicenter trial of dovitinib 500 mg/day (5-days-on/2-days-off schedule). The primary endpoint was 16-week progression-free survival (PFS). Secondary endpoints were overall survival (OS), toxicity and prostate-specific antigen (PSA) response rate. Biomarker analyses for VEGFR2, FGF23, and FGFR2 using multiplex enzyme-linked immunosorbent assay was performed. RESULTS: Forty-four men were accrued from 11 hospitals. Eighty percent were post-docetaxel. Median PSA was 100 ng/dL, median age was 69, 82% had bone metastases, and 23% had liver metastases. Median cycles of dovitinib was 2 (range, 0 to 33). Median PFS was 3.67 months (95% confidence interval [CI], 1.36 to 5.98) and median OS was 13.70 months (95% CI, 0 to 27.41). Chemotherapy-naïve patients had longer PFS (17.90 months; 95% CI, 9.23 to 28.57) compared with docetaxel-treated patients (2.07 months; 95% CI, 1.73 to 2.41; p=0.001) and the patients with high serum VEGFR2 level over median level (7,800 pg/mL) showed longer PFS compared with others (6.03 months [95% CI, 4.26 to 7.80] vs. 1.97 months [95% CI, 1.79 to 2.15], p=0.023). Grade 3 related adverse events were seen in 40.9% of patients. Grade 1-2 nausea, diarrhea, fatigue, anorexia, and all grade thrombocytopenia are common. CONCLUSION: Dovitinib showed modest antitumor activity with manageable toxicities in men with mCRPC. Especially, patients who were chemo-naïve benefitted from dovitinib.
Anorexia
;
Biomarkers
;
Carcinogenesis
;
Castration
;
Diarrhea
;
Disease-Free Survival
;
Enzyme-Linked Immunosorbent Assay
;
Fatigue
;
Fibroblast Growth Factors
;
Humans
;
Liver
;
Male
;
Multicenter Studies as Topic
;
Nausea
;
Neoplasm Metastasis
;
Prostate*
;
Prostate-Specific Antigen
;
Prostatic Neoplasms*
;
Prostatic Neoplasms, Castration-Resistant
;
Receptors, Fibroblast Growth Factor
;
Receptors, Platelet-Derived Growth Factor
;
Receptors, Vascular Endothelial Growth Factor
;
Thrombocytopenia
8.Hypospadias induced by maternal exposure to di-n-butyl phthalate and its mechanisms in male rat offspring
En-Hui LI ; Hai-Bin WEI ; Bang-Gao LHUANGI ; En-Hui LI ; Qi ZHANG ; Zhi-Hui XU ; Da-Hong ZHANG
National Journal of Andrology 2017;23(12):1063-1068
Objective:
To induce hypospadias in male rat offspring by maternal exposure to di-n-butyl phthalate (DBP) during late pregnancy and further investigate its mechanisms.
METHODS:
We randomly divided 20 pregnant rats into a DBP exposure and a control group, the former treated intragastrically with DBP while the latter with soybean oil at 750 mg per kilogram of the body weight per day from gestation days (GD) 14 to 18. On postnatal day (PND) 1, we recorded the incidence rate of hypospadias and observed the histopathological changes in the genital tubercle of the hypospadiac rats. We also measured the level of serum testosterone (T) by radioimmunoassay and determined the mRNA and protein expressions of the androgen receptor (AR), sonic hedgehog (Shh), bone morphogenetic protein 4 (Bmp4) and fibroblast growth factor 8 (Fgf8) in the genital tubercle by real-time PCR and Western blot.
RESULTS:
No hypospadiac male rats were found in the control group. The incidence rate of hypospadias in male offspring was 43.6% in the DBP-treatment group. Histological analysis confirmed hypospadiac malformation. The serum testosterone concentration was decreased in the hypospadiac male rats as compared with the controls ([0.49 ± 0.05] vs [1.12 ± 0.05] ng/ml, P <0.05). The mRNA expressions of AR, Shh, Bmp4 and Fgf8 in the genital tubercle were significantly lower in the hypospadiac male rats than in the controls (AR: 0.50 ± 0.05 vs 1.00 ± 0.12, P <0.05; Shh: 0.65 ± 0.07 vs 1.00 ± 0.15, P <0.05; Bmp4: 0.42 ± 0.05 vs 1.00 ± 0.13, P <0.05; Fgf8: 0.46 ± 0.04 vs 1.00 ± 0.12, P <0.05), and so were their protein expressions (AR: 0.34 ± 0.05 vs 1.00 ± 0.09, P <0.05; Shh: 0.51 ± 0.07 vs 1.00 ± 0.12, P <0.05; Bmp4: 0.43 ± 0.05 vs 1.00 ± 0.11, P <0.05; Fgf8: 0.57 ± 0.04 vs 1.00 ± 0.13, P <0.05).
CONCLUSIONS
Maternal exposure to DBP during late pregnancy can induce hypospadias in the male rat offspring. DBP affects the development of the genital tubercle by reducing the serum T concentration and expressions of AR, Shh, Bmp4 and Fgf8 in the genital tubercle, which might underlie the mechanism of DBP inducing hypospadias.
Animals
;
Body Weight
;
Bone Morphogenetic Protein 4
;
blood
;
Dibutyl Phthalate
;
toxicity
;
Female
;
Fibroblast Growth Factor 8
;
blood
;
Hedgehog Proteins
;
blood
;
Hypospadias
;
blood
;
chemically induced
;
pathology
;
Male
;
Maternal Exposure
;
Plasticizers
;
toxicity
;
Pregnancy
;
RNA, Messenger
;
blood
;
Random Allocation
;
Rats
;
Rats, Sprague-Dawley
;
Receptors, Androgen
;
blood
;
Soybean Oil
;
Testosterone
;
blood
9.VEGF and Ki-67 Overexpression in Predicting Poor Overall Survival in Adenoid Cystic Carcinoma.
Seongyeol PARK ; Soo Jeong NAM ; Bhumsuk KEAM ; Tae Min KIM ; Yoon Kyung JEON ; Se Hoon LEE ; J Hun HAH ; Tack Kyun KWON ; Dong Wan KIM ; Myung Whun SUNG ; Dae Seog HEO ; Yung Jue BANG
Cancer Research and Treatment 2016;48(2):518-526
PURPOSE: The purpose of this study was to evaluate potential prognostic factors in patients with adenoid cystic carcinoma (ACC). MATERIALS AND METHODS: A total of 68 patients who underwent curative surgery and had available tissue were enrolled in this study. Their medical records and pathologic slides were reviewed and immunohistochemistry for basic fibroblast growth factor, fibroblast growth factor receptor (FGFR) 2, FGFR3, c-kit, Myb proto-oncogene protein, platelet-derived growth factor receptor beta, vascular endothelial growth factor (VEGF), and Ki-67 was performed. Univariate and multivariate analysis was performed for determination of disease-free survival (DFS) and overall survival (OS). RESULTS: In univariate analyses, primary site of nasal cavity and paranasal sinus (p=0.022) and Ki-67 expression of more than 7% (p=0.001) were statistically significant factors for poor DFS. Regarding OS, perineural invasion (p=0.032), high expression of VEGF (p=0.033), and high expression of Ki-67 (p=0.007) were poor prognostic factors. In multivariate analyses, primary site of nasal cavity and paranasal sinus (p=0.028) and high expression of Ki-67 (p=0.004) were independent risk factors for poor DFS, and high expression of VEGF (p=0.011) and Ki-67 (p=0.011) showed independent association with poor OS. CONCLUSION: High expression of VEGF and Ki-67 were independent poor prognostic factors for OS in ACC.
Adenoids*
;
Carcinoma, Adenoid Cystic*
;
Disease-Free Survival
;
Fibroblast Growth Factor 2
;
Humans
;
Immunohistochemistry
;
Medical Records
;
Multivariate Analysis
;
Nasal Cavity
;
Prognosis
;
Proto-Oncogenes
;
Receptors, Fibroblast Growth Factor
;
Receptors, Platelet-Derived Growth Factor
;
Risk Factors
;
Vascular Endothelial Growth Factor A*
10.Prognosis of Pregnancy-Associated Gastric Cancer: An Age-, Sex-, and Stage-Matched Case-Control Study.
Min Jeong SONG ; Young Soo PARK ; Ho June SONG ; Se Jeong PARK ; Ji Yong AHN ; Kee Don CHOI ; Gin Hyug LEE ; Hwoon Yong JUNG ; Jeong Hwan YOOK ; Byung Sik KIM
Gut and Liver 2016;10(5):731-738
BACKGROUND/AIMS: Pregnancy-associated gastric cancer is a rare condition. This case-control study was performed to identify the clinicopathological features and prognostic factors of pregnancy-associated gastric cancer. METHODS: All consecutive patients who presented to our tertiary referral hospital with pregnancy-associated gastric cancer from 1991 to 2012 were identified. Two age-, sex-, and stage-matched controls for each case were also identified from the records. Clinicopathological, gynecological, and oncological outcomes were recorded. Immunohistochemical staining was performed for estrogen receptor, progesterone receptor, epidermal growth factor receptor, human epidermal growth factor receptor, and E-cadherin. Fluorescence in situ hybridization was performed for fibroblast growth factor receptor 2. RESULTS: The median overall survival rates of the pregnancy-associated gastric cancer and control groups were 7.0 months and 15.0 months, respectively (p=0.189). Poor prognostic factors included advanced stage and tumor location in the corpus or the entire stomach but not pregnancy status or loss of E-cadherin. Pregnancy-associated gastric cancer was associated with a longer time from diagnosis to treatment (21 days vs 7 days, p=0.021). The two groups did not differ in the expression of the receptors or E-cadherin. CONCLUSIONS: The dismal prognosis of pregnancy-associated gastric cancer may related to the tumor stage and location rather than to pregnancy itself.
Cadherins
;
Case-Control Studies*
;
Diagnosis
;
Estrogens
;
Fluorescence
;
Humans
;
In Situ Hybridization
;
Pregnancy
;
Prognosis*
;
Receptor, Epidermal Growth Factor
;
Receptor, Fibroblast Growth Factor, Type 2
;
Receptors, Progesterone
;
Stomach
;
Stomach Neoplasms*
;
Survival Rate
;
Tertiary Care Centers

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