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A synthesis of 52 articles links depression to activation of the sympathetic nervous system and the hypothalamic-pituitary-adrenal axis, promoting catecholamine release and tumor progression via pathways such as the β2-adrenergic receptor. Depression severity correlates with GC progression indicators, while GC can worsen depression through psychosocial, cognitive, and tumor- and treatment-related biological mechanisms, forming a vicious cycle and supporting clinical interventions.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/bidirectional-relationship-between-depression-and-the-risk-and-prognosis-of-gastric-cancer/406575/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/bidirectional-relationship-between-depression-and-the-risk-and-prognosis-of-gastric-cancer/406575.png","ImageObject",300,407,{"name":92,"@type":93},"Mabel","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-31","2026-09-28",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What bidirectional relationship does the minireview describe?","Question",{"text":113,"@type":114},"The minireview describes how depression influences the risk and progression of gastric cancer and how gastric cancer can induce or worsen depression, creating a vicious cycle.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"Which biological mechanisms are linked to depression’s effect on gastric cancer?",{"text":118,"@type":114},"It highlights activation of the sympathetic nervous system and the hypothalamic-pituitary-adrenal axis, leading to catecholamine release and effects on proliferation, invasion, and metastasis through signaling pathways such as the β2-adrenergic receptor.",{"name":120,"@type":111,"acceptedAnswer":121},"How does gastric cancer contribute to depression?",{"text":122,"@type":114},"The review attributes this to psychological and cognitive factors, social environment interactions, and pathophysiological mechanisms including tumor biology, treatment-related damage, and metabolic disorders.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},406575,1791300276,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":39,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":46,"preview_page_count":4},7971474920318,"https://ap-avatar.wpscdn.com/avatar/74000ee537e6b0ca360?x-image-process=image/resize,m_fixed,w_180,h_180&k=1788430171632181674","| W | J | G | O | World Journal of\u003Cbr>Gastrointestinal Oncology |\n| --- | --- | --- | --- | --- |\n\nSubmit a Manuscript: [https://www.f6publishing.com](https://www.f6publishing.com) World J Gastrointest Oncol 2025 December 15; 17(12): 113272  \nDOI: 10.4251/wjgo.v17.i12.113272 ISSN 1948-5204 (online)  \nMINIREVIEWS  \nBidirectional relationship between depression and the risk and prognosis of gastric cancer  \nZhe Chen, Ting-Jie Gong, Lu Zhao  \nSpecialty type: Oncology  \nProvenance and peer review:  \nUnsolicited article; Externally peer reviewed.  \nPeer-review model: Single blind  \nPeer-review report’s classification Scientific Quality: Grade B, Grade C  \nNovelty: Grade B, Grade C  \nCreativity or Innovation: Grade B, Grade C  \nScientific Significance: Grade B, Grade C  \nP-Reviewer: Bell RJ, PhD, United Kingdom; van Rossum PSN, MD, PhD, Netherlands  \nReceived: August 26, 2025  \nRevised: September 26, 2025  \nAccepted: November 7, 2025  \nPublished online: December 15, 2025  \nProcessing time: 107 Days and 0.4 Hours  \nZhe Chen, Ting-Jie Gong, Lu Zhao, Department of Oncology, Wuxi Hospital Affiliated to  \nNanjing University of Traditional Chinese Medicine, Wuxi 214000, Jiangsu Province, China Co-first authors: Zhe Chen and Ting-Jie Gong.  \nCorresponding author: Lu Zhao, Department of Oncology, Wuxi Hospital Affiliated to Nanjing University of Traditional Chinese Medicine, No. 8 Zhongnan West Road, Binhu District, Wuxi 214000, Jiangsu Province, [China.](China. lorraine0318@163.com)[ lorraine0318@163.com](China. lorraine0318@163.com)  \nAbstract  \nGastric cancer (GC) is a highly prevalent and life-threatening malignant tumor worldwide, posing a serious threat to human health. Depression is also highly prevalent among patients with GC. A complex bidirectional relationship exists between the two. A total of 52 articles were included in this study to synthesize the evidence on the association between depression and the risk of GC as well asthe prognosis of affected patients. The findings indicated that depression can activate the sympathetic nervous system and the hypothalamic-pituitary-adrenal axis, promote the release of catecholamine neurotransmitters, and influence the proliferation, invasion, and metastasis of GC through signaling pathways such asthe β2-adrenergic receptor. Furthermore, the severity of depression is positively correlated with indicators of GC progression. At the same time, GC can induce or aggravate depression through psychological and cognitive factors, social environment interactions, and diverse pathophysiological mechanisms, including tumor biological characteristics, treatment-related damage, and metabolic disorders. These interactions form a vicious cycle. This minireview summarizes the existing evidence and provides a theoretical basis for clinical interventions aimed at improving treatment outcomes and quality of life in patients with GC.  \nKey Words: Gastric cancer; Depression; Bidirectional relationship; Psychological factors; Quality of life  \n©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.  \n WJGO  [https://www.wjgnet.com](https://www.wjgnet.com) 1 December 15, 2025  Volume 17  Issue 12   \nChen Z et al. Depression and GC risk/prognosis  \nCore Tip: This minireview reveals a bidirectional relationship between depression and gastric cancer. Depression activates the sympathetic nervous system and the hypothalamic-pituitary-adrenal axis, promoting tumor progression through pathways such as the β2-adrenergic receptor. Conversely, gastric cancer induces depression through psychosocial and pathophysiological mechanisms. This vicious cycle provides a theoretical basis for clinical interventions designed to improve patient outcomes and quality of life.  \nCitation: Chen Z, Gong TJ, Zhao L. Bidirectional relationship between depression and the risk and prognosis of gastric cancer. World J Gastrointest Oncol 2025; 17(12): 113272  \nURL: [https://www.wjgnet.com/1948-5204/full/v17/i12/1","cbCaifmyTWkfcX0U","https://ap.wps.com/l/cbCaifmyTWkfcX0U","pdf",938779,"English","# Abstract\n# Key Words\n# Core Tip\n# Introduction","[{\"question\":\"What bidirectional relationship does the minireview describe?\",\"answer\":\"The minireview describes how depression influences the risk and progression of gastric cancer and how gastric cancer can induce or worsen depression, creating a vicious cycle.\"},{\"question\":\"Which biological mechanisms are linked to depression’s effect on gastric cancer?\",\"answer\":\"It highlights activation of the sympathetic nervous system and the hypothalamic-pituitary-adrenal axis, leading to catecholamine release and effects on proliferation, invasion, and metastasis through signaling pathways such as the β2-adrenergic receptor.\"},{\"question\":\"How does gastric cancer contribute to depression?\",\"answer\":\"The review attributes this to psychological and cognitive factors, social environment interactions, and pathophysiological mechanisms including tumor biology, treatment-related damage, and metabolic disorders.\"}]","Bidirectional relationship between depression and the risk and prognosis of gastric cancer | PDF",1790566502]