Short-term survival and safety of apatinib combined with oxaliplatin and S-1 in the conversion therapy of unresectable gastric cancer.

BACKGROUND: We conducted a single-arm phase II trial to investigate the short-term efficacy and safety of apatinib combined with oxaliplatin and S-1 in the treatment of unresectable gastric cancer. PATIENTS AND METHODS: Previously untreated patients with unresectable HER-2-negative advanced gastric cancer were selected. All the patients received six cycles of S-1 and oxaliplatin and five cycles of apatinib, which were administered at intervals of three weeks. The surgery was performed after six cycles of drug treatment. The primary endpoints were radical resection (R0) rate and safety. This study was registered with the China Trial Register, number ChiCTR-ONC-17010430  (01/12/2016-01/12/2022). RESULTS: A total of 39 patients were enrolled. Efficacy evaluation was feasible for 37 patients. One patient achieved complete response (CR, 2.7%), 26 patients achieved partial response (PR, 70.3%), three patients had stable disease (SD, 8.1%) and seven patients had progressive disease (PD, 18.9%). The objective response rate (ORR) was 73.0% and the disease control rate (DCR) was 81.1%. 22 patients underwent surgery, among which 14 patients underwent radical resection (R0), with a R0 resection rate of 63.6%. The 1-year survival rate of the surgical group (22 patients) was 71.1% and the 2-year survival rate was 41.1%. The median survival time was 21 months. The incidence of adverse events (AEs) was 100%. Leucopenia (65.3%) and granulocytopenia (69.2%) were the most common hematological AEs. The most common non-hematological AEs were fatigue (51.3%) and oral mucositis (35.9%). CONCLUSION: Apatinib combined with oxaliplatin and S-1 showed good short-term survival and acceptable safety in the conversion therapy of unresectable gastric cancer.

Prognostic value of preoperative body mass index for diabetic patients with non-metastasis gastric cancer: a single center experience.

AIM: This study was designed to investigate the prognostic effect of preoperative body mass index (BMI) for Type 2 diabetes mellitus (T2DM) patients with non-metastasis gastric cancer (GC) who underwent D2 gastrectomy. METHODS: T2DM patients with pT1-4bN0-3bM0 GC were retrospectively collected in Department of Gastrointestinal Surgical Oncology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital from January, 2000 to December, 2010. These patients underwent D2 radical resection of the stomach combined with regional lymphadenectomy. Chi-square test was used to analyze unordered categorical variables and ranked data, followed by Kaplan-Meier analysis as well as Cox regression models to detect risk factors for survival outcomes. In addition, the cut-off point was determined by the X-tile program. All analyses were carried out using survival package of R and SPSS Software. RESULTS: A total of 302 T2DM patients with pT1-4bN0-3bM0 GC were collected and analyzed. The cut-off points of BMI, identified by the X-tile program, was 19 kg/m2. Patients with low BMI (< 19 kg/m2) had a higher percentage of advanced T stage (T4a and T4b), more advanced TNM stage (stage IIIA, IIIB and IIIC), and more elevated level of serum carcinoembryonic antigen (CEA), compared to those with high BMI (> 19 kg/m2) (all P < 0.05). In the low BMI subgroup, the 5-year overall survival rate was 39.02%, which was as high as 58.11% in the high BMI subgroup (P < 0.05). In the multivariate Cox regression model revealed that IIIC stage (OR = 3.101), N3b stage (OR = 3.113) were the most important prognostic indicators, followed by pretreatment BMI (OR = 2.136). CONCLUSION: Low preoperative BMI (< 19 kg/m2) was a poor prognostic marker for T2DM patients with pT1-4bN0-3bM0 GC.

Rare heterochronous liver and pancreatic multiple primary cancers: a case report and literature review.

In recent years, with the continuous improvement of medical diagnostic techniques, the incidence of multiple primary carcinoma (MPC) has increased gradually. Elderly patients are at high risk of MPC. However, the risk of developing a second primary malignancy is 1 % for primary liver malignancy 1. The risk of pancreatic cancers as secondary malignancies with primary liver malignancy is very rare. Here, we report a rare case of heterochronous liver and pancreatic MPCs and review the related literature. We report this case to raise the clinician's attention to the disease because the long-term survival rate can be effectively improved by timely diagnosis and appropriate treatment. For patients with HCV-positive primary cancers, active antiviral therapy should be simultaneously provided with antitumor therapy, thereby effectively reducing the incidence of MPC.

Automatic QRS complex detection using two-level convolutional neural network.

BACKGROUND: The QRS complex is the most noticeable feature in the electrocardiogram (ECG) signal, therefore, its detection is critical for ECG signal analysis. The existing detection methods largely depend on hand-crafted manual features and parameters, which may introduce significant computational complexity, especially in the transform domains. In addition, fixed features and parameters are not suitable for detecting various kinds of QRS complexes under different circumstances. METHODS: In this study, based on 1-D convolutional neural network (CNN), an accurate method for QRS complex detection is proposed. The CNN consists of object-level and part-level CNNs for extracting different grained ECG morphological features automatically. All the extracted morphological features are used by multi-layer perceptron (MLP) for QRS complex detection. Additionally, a simple ECG signal preprocessing technique which only contains difference operation in temporal domain is adopted. RESULTS: Based on the MIT-BIH arrhythmia (MIT-BIH-AR) database, the proposed detection method achieves overall sensitivity Sen = 99.77%, positive predictivity rate PPR = 99.91%, and detection error rate DER = 0.32%. In addition, the performance variation is performed according to different signal-to-noise ratio (SNR) values. CONCLUSIONS: An automatic QRS detection method using two-level 1-D CNN and simple signal preprocessing technique is proposed for QRS complex detection. Compared with the state-of-the-art QRS complex detection approaches, experimental results show that the proposed method acquires comparable accuracy.

Prevalence and risk evaluation of cardiovascular disease in the newly diagnosed prostate cancer population in China: A nationwide, multi-center, population-based cross-sectional study.

BACKGROUND: Cardiovascular disease (CVD) has emerged as the leading cause of death from prostate cancer (PCa) in recent decades, bringing a great disease burden worldwide. Men with preexisting CVD have an increased risk for major adverse cardiovascular events when treated with androgen deprivation therapy (ADT). The present study aimed to explore the prevalence and risk evaluation of CVD among people with newly diagnosed PCa in China. METHODS: Clinical data of newly diagnosed PCa patients were retrospectively collected from 34 centers in China from 2010 to 2022 through convenience sampling. CVD was defined as myocardial infarction, arrhythmia, heart failure, stroke, ischemic heart disease, and others. CVD risk was estimated by calculating Framingham risk scores (FRS). Patients were accordingly divided into low-, medium-, and high-risk groups. χ2 or Fisher's exact test was used for comparison of categorical variables. RESULTS: A total of 4253 patients were enrolled in the present study. A total of 27.0% (1147/4253) of patients had comorbid PCa and CVD, and 7.2% (307/4253) had two or more CVDs. The enrolled population was distributed in six regions of China, and approximately 71.0% (3019/4253) of patients lived in urban areas. With imaging and pathological evaluation, most PCa patients were diagnosed at an advanced stage, with 20.5% (871/4253) locally progressing and 20.5% (871/4253) showing metastasis. Most of them initiated prostatectomy (46.6%, 1983/4253) or regimens involving ADT therapy (45.7%, 1944/4253) for prostate cancer. In the present PCa cohort, 43.1% (1832/4253) of patients had hypertension, and half of them had poorly controlled blood pressure. With FRS stratification, as expected, a higher risk of CVD was related to aging and metabolic disturbance. However, we also found that patients with treatment involving ADT presented an originally higher risk of CVD than those without ADT. This was in accordance with clinical practice, i.e., aged patients or patients at advanced oncological stages were inclined to accept systematic integrative therapy instead of surgery. Among patients who underwent medical castration, only 4.0% (45/1118) received gonadotropin releasing hormone antagonists, in stark contrast to the grim situation of CVD prevalence and risk. CONCLUSIONS: PCa patients in China are diagnosed at an advanced stage. A heavy CVD burden was present at the initiation of treatment. Patients who accepted ADT-related therapy showed an original higher risk of CVD, but the awareness of cardiovascular protection was far from sufficient.

High-Sensitivity PtSe2 Surface Plasmon Resonance Biosensor Based on Metal-Si-Metal Waveguide Structure.

PtSe2 as a novel TMDCs material is used to modify the traditional SPR biosensors to improve the performance. On this basis, this research proposes a metal-Si-metal waveguide structure to further improve the performance of the biosensor. In this study, we not only studied the effects of waveguide structures containing different metals on the performance of biosensor, but also discussed the performance change of the biosensor with the change of PtSe2 thickness. After the final optimization, a BK7-Au-Si-Au-PtSe2 (2 nm) biosensor structure achieved the highest sensitivity of 193.8°/RIU. This work provides a new development idea for the study of SPR biosensors with waveguide structures in the future.

Mechanical Properties, Crystallization Behaviors and Phase Morphologies of PLA/GTR Blends by Reactive Compatibilization.

Different ratios of Polylactic acid/Ground tire rubber (PLA/GTR) were prepared by melt blending and adding dicumyl peroxide (DCP) as a reactive compatibilizer. The compatibilizer could initiate a reaction between PLA and GTR to increase the compatibility and interfacial adhesion of the two phases, as indicated by Fourier transform infrared (FTIR) spectrometry and scanning electron microscopy (SEM). Adding the compatibilizer significantly improved the impact strength of the PLA/GTR blends without compromising the tensile strength. The elongation at the break and notched Izod impact strength of the blend increased by 61.8% and 150%, respectively, but there was only a 4.1% decline in tensile strength compared with the neat PLA. The plastic deformation on the impact fractured surface showed that the improvement of toughness could be attributed to the compatibilization initiated by DCP. Therefore, the improvement of the interfacial adhesion and compatibility of the two phases induced a brittle-ductile transition that occurred in the failure of blends. Moreover, the crystallinity of blends reached 40.5% without a further annealing treatment, which was nearly 24 times of the neat PLA, and the crystallization rate was enhanced simultaneously. These exciting findings suggest that compatibilization can provide a promising avenue for fabricating GTR-toughened PLA blends with balanced stiffness-toughness.

Enhanced Photodetection Range from Visible to Shortwave Infrared Light by ReSe2/MoTe2 van der Waals Heterostructure.

Type II vertical heterojunction is a good solution for long-wavelength light detection. Here, we report a rhenium selenide/molybdenum telluride (n-ReSe2/p-MoTe2) photodetector for high-performance photodetection in the broadband spectral range of 405-2000 nm. Due to the low Schottky barrier contact of the ReSe2/MoTe2 heterojunction, the rectification ratio (RR) of ~102 at ±5 V is realized. Besides, the photodetector can obtain maximum responsivity (R = 1.05 A/W) and specific detectivity (D* = 6.66 × 1011 Jones) under the illumination of 655 nm incident light. When the incident wavelength is 1550-2000 nm, a photocurrent is generated due to the interlayer transition of carriers. This compact system can provide an opportunity to realize broadband infrared photodetection.

Effect of Carbon Nanotubes on the Mechanical, Crystallization, Electrical and Thermal Conductivity Properties of CNT/CCF/PEKK Composites.

Carbon nanotube/continuous carbon fiber-reinforced poly(etherketoneketone) (CNT/CCF/PEKK) prepreg tapes were prepared by the wet powder impregnation method, and then the prepreg tapes were molded into laminates. The effects of carbon nanotubes on the mechanical properties, conductivity, thermal conductivity and crystallinity of the composites were studied by universal testing machine, thermal conductivity and resistivity tester, dynamic mechanical analyzer (DMA) and differential scanning calorimeter (DSC). The results show that when the content of carbon nanotubes is 0.5 wt% (relative to the mass of PEKK resin, the same below), the flexural strength and interlaminar shear strength of the laminates reach the maximum, which are increased by 15.99% and 18.16%, respectively, compared with the laminates without carbon nanotubes. The results of conductivity and thermal conductivity show that the higher the content of carbon nanotubes, the better the conductivity and thermal conductivity of the material. DSC results show that the addition of CNT promoted the crystallization of PEKK in the material and decreased the cold crystallization of PEKK. DMA results show that the deformation resistance of the material can be improved by adding an appropriate amount of CNT and the bonding between CF and PEKK can be enhanced, while excessive CNT destroys this phenomenon.

Effects of the Interlayer Toughening Agent Structure on the Flow Behavior during the z-RTM Process.

In this paper, interlayer toughening composites were prepared by the z-directional injection RTM process (z-RTM), which has the advantage of increasing the interlaminar toughness and shortening the filling time and completely impregnating the fibers. The nonwoven fabrics and dot matrix structure material were used as ex situ interlayer toughening agents. The effect of the interlayer toughening agent structure on the resin flow behavior during the z-RTM process was investigated. The macro-flowing and micro-infiltration behaviors of the resin inside the preforms were deduced. The permeability of the fabric preforms with different toughening agents was investigated. The results show that the introduction of the nonwoven structure toughening agent makes the macro flow slow, and the flow front more uniform. The toughening agent with a dot matrix structure promotes the resin macro flow in the preforms, and shortens the injection time. The z-directional permeability of the preform with a dot matrix structural toughening agent is one order of magnitude lower than that of the non-toughened preform, while being higher than the preform toughened by the nonwoven fabric preforms, which is helpful for the further applicability of the z-RTM process. Furthermore, the mode II interlaminar fracture toughness of composites was evaluated.

High Expression of FCRLB Predicts Poor Prognosis in Patients With Colorectal Cancer.

Background: Mining the prognostic biomarkers of colorectal cancer (CRC) has important clinical and scientific significance. The role of Fc receptor-like B (FCRLB) in solid tumors has never been reported or studied to our knowledge, and the prognostic role of FCRLB in CRC still awaits characterization. Methods: The potential prognostic factor FCRLB was screened out through TCGA database analysis. Then, its expression and associations with clinicopathological variables were assessed in the TCGA CRC cohort. The prognostic value of FCRLB was examined with multiple methods, such as the Kaplan-Meier method, ROC curve, time-dependent ROC analysis, and prediction model nomograms. Then, functional enrichment and annotation among the high and low FCRLB groups were achieved utilizing GO and KEGG analyses and GSEA. Fresh CRC tissue samples obtained clinically were used for the preparation of the tissue microarray and for further validation. Results: FCRLB was highly expressed in CRC tissues compared to normal tissues. Moreover, over-expression of FCRLB correlated with higher CEA levels, advanced T stage, N stage, M stage, AJCC stage, lymphatic invasion, perineural invasion, and incomplete resection (R1 and R2 resection). In addition, high expression of FCRLB was closely correlated to less favorable OS, DSS, and PFI. The analysis of CRC tissue microarray further confirmed the conclusion drawn from the TCGA data analysis. Conclusion: FCRLB is notably up-regulated in CRC tissues and may serve as a potential biomarker of CRC.

Corrigendum: Bioinformatics Analysis Reveals an Association Between Cancer Cell Stemness, Gene Mutations, and the Immune Microenvironment in Stomach Adenocarcinoma.

[This corrects the article DOI: 10.3389/fgene.2020.595477.].

A nomogram for clinical estimation of acute biliary pancreatitis risk among patients with symptomatic gallstones: A retrospective case-control study.

Background/Purpose: Currently, there are no effective tools to accurately assess acute biliary pancreatitis (ABP) risk in patients with gallstones. This study aimed to develop an ABP risk nomogram in patients with symptomatic gallstones. Methods: We conducted a retrospective nested case-control study and data on 816 conservatively treated patients with symptomatic gallstones admitted to The First Affiliated Hospital of Harbin Medical University between January 6, 2007 and January 22, 2016 were retrospectively collected. We conducted a propensity-score matched (PSM) analysis based on follow-up time in a ratio of 1:4 between ABP group (n=65) and non-ABP group (n=260). These matched patients were randomly divided into study cohort (n=229) and validation cohort (n=96) according to a ratio of 7:3. In the study cohort, independent risk factors for ABP occurrence identified using Cox regression were included in nomogram. Nomogram performance and discrimination were assessed using the concordance index (C-index), area under the curve (AUC), calibration curve, decision curve analysis (DCA) and clinical impact curve (CIC). The model was also validated in the validation cohort. Results: Nomogram was based on 7 independent risk factors: age, diabetes history, gallbladder wall thickness, gallstone diameter, coexisting common bile duct (CBD) stones, direct bilirubin (DBIL), and white blood cell count (WBC). The C-index of nomogram was 0.888, and the 10-year AUCs of nomogram was 0.955. In the validation cohort, nomogram still had good discrimination (C-index, 0.857; 10-year AUC, 0.814). The calibration curve showed good homogeneity between the prediction by nomogram and the actual observation. DCA and CIC demonstrated that nomogram was clinically useful. Conclusions: The ABP risk nomogram incorporating 7 features is useful to predict ABP risk in symptomatic gallstone patients.

Double Perovskite Ba2LaTaO6 for Ultrafast Fiber Lasers in Anomalous and Normal Net Dispersion Regime.

Double perovskites (DPs) have been attracting attention in an assortment of optoelectronic applications, for they hold advantages such as high quantum efficiency, long carrier migration distance and strong linear and nonlinear absorptions. As specific kinds of perovskites (PVKs), DPs are gifted with orthorhombic crystal structures which provide rich conversion combinations and broaden the space for research and application. However, few works have been reported about DPs in ultrafast photonics applications. In this article, a DP with chemical formula of Ba2LaTaO6 (BLT) was successfully synthesized by high-temperature solid phase method. The microstructures and morphologies were observed, and the linear and nonlinear absorption were characterized. By first using BLT as a novel saturable absorber in both normal and anomalous dispersion region fiber lasers, dual-wavelength soliton and dissipative soliton were successfully operated at C-band. This study affirms BLT's nonlinear optical properties, lays the foundation for optical research on BLT, and meanwhile provides a meaningful reference for future development of pulsed lasers based on DPs.

2D BP/InSe Heterostructures as a Nonlinear Optical Material for Ultrafast Photonics.

The BP/InSe heterojunction has attracted the attention of many fields in successful combined high hole mobility of black phosphorus (BP) and high electron mobility of indium selenide (InSe), and enhanced the environmental stability of BP. Nevertheless, photonics research on the BP/InSe heterostructure was insufficient, while both components are considered promising in the field. In this work, a two-dimensional (2D) BP/InSe heterostructure was fabricated using the liquid-phase exfoliation method. Its linear and non-linear optical (NLO) absorption was characterized by ultraviolet-visible-infrared and Open-aperture Z-scan technology. On account of the revealed superior NLO properties, an SA based on 2D BP/InSe was prepared and embedded into an erbium-doped fiber laser, traditional soliton pulses were observed at 1.5 µm with the pulse duration of 881 fs. Furthermore, harmonic mode locking of bound solitons and dark-bright soliton pairs were also obtained in the same laser cavity due to the cross-coupling effect. The stable mode-locked operation can be maintained for several days, which overcome the low air stability of BP. This contribution further proves the excellent optical properties of 2D BP/InSe heterostructure and provides new probability of developing nano-photonics devices for the applications of double pulses laser source and long-distance information transmission.

CircRNAs: a new target for the diagnosis and treatment of digestive system neoplasms.

A circRNA is a type of endogenous noncoding RNA that consists of a closed circular RNA molecule formed by reverse splicing; these RNAs are widely distributed in a variety of biological cells. In contrast to linear RNAs, circRNAs have no 5' cap or 3' poly(A) tail. They have a stable structure, a high degree of conservation, and high stability, and they are richly and specifically expressed in certain tissues and developmental stages. CircRNAs play a very important role in the occurrence and progression of malignant tumors. According to their origins, circRNAs can be divided into four types: exon-derived circRNAs (ecRNAs), intron-derived circRNAs (ciRNAs), circRNAs containing both exons and introns (EIciRNAs) and intergenic circRNAs. A large number of studies have shown that circRNAs have a variety of biological functions, participate in the regulation of gene expression and play an important role in the occurrence and progression of tumors. In this paper, the structure and function of circRNAs are reviewed, along with their biological role in malignant tumors of the digestive tract, in order to provide a reference for the diagnosis and treatment of digestive system neoplasms.

A 13-Gene Metabolic Prognostic Signature Is Associated With Clinical and Immune Features in Stomach Adenocarcinoma.

Patients with advanced stomach adenocarcinoma (STAD) commonly show high mortality and poor prognosis. Increasing evidence has suggested that basic metabolic changes may promote the growth and aggressiveness of STAD; therefore, identification of metabolic prognostic signatures in STAD would be meaningful. An integrative analysis was performed with 407 samples from The Cancer Genome Atlas (TCGA) and 433 samples from Gene Expression Omnibus (GEO) to develop a metabolic prognostic signature associated with clinical and immune features in STAD using Cox regression analysis and least absolute shrinkage and selection operator (LASSO). The different proportions of immune cells and differentially expressed immune-related genes (DEIRGs) between high- and low-risk score groups based on the metabolic prognostic signature were evaluated to describe the association of cancer metabolism and immune response in STAD. A total of 883 metabolism-related genes in both TCGA and GEO databases were analyzed to obtain 184 differentially expressed metabolism-related genes (DEMRGs) between tumor and normal tissues. A 13-gene metabolic signature (GSTA2, POLD3, GLA, GGT5, DCK, CKMT2, ASAH1, OPLAH, ME1, ACYP1, NNMT, POLR1A, and RDH12) was constructed for prognostic prediction of STAD. Sixteen survival-related DEMRGs were significantly related to the overall survival of STAD and the immune landscape in the tumor microenvironment. Univariate and multiple Cox regression analyses and the nomogram proved that a metabolism-based prognostic risk score (MPRS) could be an independent risk factor. More importantly, the results were mutually verified using TCGA and GEO data. This study provided a metabolism-related gene signature for prognostic prediction of STAD and explored the association between metabolism and the immune microenvironment for future research, thereby furthering the understanding of the crosstalk between different molecular mechanisms in human STAD. Some prognosis-related metabolic pathways have been revealed, and the survival of STAD patients could be predicted by a risk model based on these pathways, which could serve as prognostic markers in clinical practice.

Erratum: MicroRNA-451a targets caveolin-1 in stomach cancer cells.

[This corrects the article on p. 2524 in vol. 13, PMID: 33165443.].

Survival-associated alternative splicing events interact with the immune microenvironment in stomach adenocarcinoma.

BACKGROUND: Alternative splicing (AS) increases the diversity of mRNA during transcription; it might play a role in alteration of the immune microenvironment, which could influence the development of immunotherapeutic strategies against cancer. AIM: To obtain the transcriptomic and clinical features and AS events in stomach adenocarcinoma (STAD) from the database. The overall survival data associated with AS events were used to construct a signature prognostic model for STAD. METHODS: Differentially expressed immune-related genes were identified between subtypes on the basis of the prognostic model. In STAD, 2042 overall-survival-related AS events were significantly enriched in various pathways and influenced several cellular functions. Furthermore, the network of splicing factors and overall-survival-associated AS events indicated potential regulatory mechanisms underlying the AS events in STAD. RESULTS: An eleven-AS-signature prognostic model (CD44|14986|ES, PPHLN1|21214|AT, RASSF4|11351|ES, KIAA1147|82046|AP, PPP2R5D|76200|ES, LOH12CR1|20507|ES, CDKN3|27569|AP, UBA52|48486|AD, CADPS|65499|AT, SRSF7| 53276|RI, and WEE1|14328|AP) was constructed and significantly related to STAD overall survival, immune cells, and cancer-related pathways. The differentially expressed immune-related genes between the high- and low-risk score groups were significantly enriched in cancer-related pathways. CONCLUSION: This study provided an AS-related prognostic model, potential mechanisms for AS, and alterations in the immune microenvironment (immune cells, genes, and pathways) for future research in STAD.

Bioinformatics Analysis Reveals an Association Between Cancer Cell Stemness, Gene Mutations, and the Immune Microenvironment in Stomach Adenocarcinoma.

Cancer stem cells (CSCs), characterized by infinite proliferation and self-renewal, greatly challenge tumor therapy. Research into their plasticity, dynamic instability, and immune microenvironment interactions may help overcome this obstacle. Data on the stemness indices (mRNAsi), gene mutations, copy number variations (CNV), tumor mutation burden (TMB), and corresponding clinical characteristics were obtained from The Cancer Genome Atlas (TCGA) and UCSC Xena Browser. Tumor purity and infiltrating immune cells in stomach adenocarcinoma (STAD) tissues were predicted using the ESTIMATE R package and CIBERSORT method, respectively. Differentially expressed genes (DEGs) between the high and low mRNAsi groups were used to construct prognostic models with weighted gene co-expression network analysis (WGCNA) and Lasso regression. The association between cancer stemness, gene mutations, and immune responses was evaluated in STAD. A total of 6,739 DEGs were identified between the high and low mRNAsi groups. DEGs in the brown (containing 19 genes) and blue (containing 209 genes) co-expression modules were used to perform survival analysis based on Cox regression. A nine-gene signature prognostic model (ARHGEF38-IT1, CCDC15, CPZ, DNASE1L2, NUDT10, PASK, PLCL1, PRR5-ARHGAP8, and SYCE2) was constructed from 178 survival-related DEGs that were significantly related to overall survival, clinical characteristics, tumor microenvironment immune cells, TMB, and cancer-related pathways in STAD. Gene correlation was significant across the prognostic model, CNVs, and drug sensitivity. Our findings provide a prognostic model and highlight potential mechanisms and associated factors (immune microenvironment and mutation status) useful for targeting CSCs.