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 [DOI: 10.4251/wjgo.v17.i12.113272]
Corresponding Author of This Article
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. lorraine0318@163.com
Research Domain of This Article
Gastroenterology & Hepatology
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Minireviews
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Dec 15, 2025 (publication date) through Dec 14, 2025
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Publication Name
World Journal of Gastrointestinal Oncology
ISSN
1948-5204
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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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 [DOI: 10.4251/wjgo.v17.i12.113272]
World J Gastrointest Oncol. Dec 15, 2025; 17(12): 113272 Published online Dec 15, 2025. doi: 10.4251/wjgo.v17.i12.113272
Bidirectional relationship between depression and the risk and prognosis of gastric cancer
Zhe Chen, Ting-Jie Gong, Lu Zhao
Zhe Chen, Ting-Jie Gong, Lu Zhao, Department of Oncology, Wuxi Hospital Affiliated to Nanjing University of Traditional Chinese Medicine, Wuxi 214000, Jiangsu Province, China
Co-first authors: Zhe Chen and Ting-Jie Gong.
Author contributions: Chen Z and Gong TJ jointly participated in study design, data collection, and manuscript drafting as co-first authors; Zhao L served as the corresponding author, overseeing the overall research process, coordinating author collaborations, addressing peer review comments, and ensuring the integrity and finalization of the manuscript. All authors have read and approved the final version.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding 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. lorraine0318@163.com
Received: August 26, 2025 Revised: September 26, 2025 Accepted: November 7, 2025 Published online: December 15, 2025 Processing time: 107 Days and 0.4 Hours
Abstract
Gastric 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 as the 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 as the 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.
Core 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.
