Study On Preoperative Identification And Related Risk Factors Of Gastric Cancer Outside Mesogastric

Objective: To study preoperative identification methods of gastric cancer outside mesogastric and screen its related risk factors,and further extend the connotation of membrane anatomy theory.Methods: Through the collection of clinical specimens,HE staining and Masson staining were used to study the mesentery structure of "moving" or "pulsatile" organs and tissues.The "V" metastatic foci of mesogastric were isolated and primary cells were cultured.According to the principle of "Koch rule",abdominal tumorigenesis were carried out repeatedly,so as to confirm that the "V" metastatic was an important risk factor for postoperative peritoneal metastasis.Through the analysis of biomedical database,the related protein coding genes that promote tumor cells to break through gastric mesangial structure were screened and analyzed.Based on the original CT images of gastric cancer patients before operation,a new web version of predictive model is constructed by using the methods of artificial intelligence and machine learning,which can help clinicians to judge extramesenteric gastric cancer before operation and make treatment plan.Results: The inner and outer mesentery of thyroid are fascia.The mesentery of the upper and middle segment of esophagus is fascia,and the mesentery of lower segment is serosa.The outer capsular tissue of vascular sheath is fascia.The outermost mesentery of the stomach and appendix tissues are serosa,containing mesothelial cells,and beneath it were fascia and adipocytes.The "V" metastatic cell isolated from the "V" metastatic foci of gastric mesentery could stably form tumors,and they were confirmed to be tumor cell by HE staining and immunohistochemical staining.Through the analysis of biomedical database,five protein coding genes(AMIGO2,COL10A1,GGT5,NOX4,VCAN)that promote tumor cells to break through gastric mesangial structure were screened,and they were significantly correlated with the level of immune cell infiltration,tumor microenvironment,tumor stem cell index and so on.Ten radiomic signatures and one clinical index were finally included in the predictive model.The AUC values of train group,test group and total patients group were 0.940(95%CI: 0.915-0.965),0.920(95%CI:0.870-0.970)and 0.931(95%CI: 0.908-0.954)respectively.The predictive ability of Radiomics plus clinical index model is significantly better than that of traditional clinical index model.Conclusions: The mesentery structure of different organs or tissues are differently,and the fascia of "moving" or "pulsatile" organs and tissues can be peeled off.In the theory of membrane anatomy,the peelability mesentery structure should include part of the fascia in addition to the serosa.The "V " metastasis cells clearly existed and can stably cause peritoneal metastases,which is a risk factor for postoperative peritoneal metastasis.In gastric cancer patients with high expression of AMIGO2,COL10A1,GGT5,NOX4 and VCAN genes,the depth of tumor invasion increased significantly,and it was easier to break through the mesogastric structure of gastric cancer.The web version of the predictive model(URL: https://hrw-doctor.shinyapps.io/Dyn Nomapp/)can well judge the gastric cancer outside mesogastric before operation and can help clinicians to make treatment plans.