Fig. 12
Schematic representation summarizes the results from the present study. Our studies indicated a connection between stress-related hormones and tumor angiogenesis in gastric cancer. In light of our observations, most patients with gastric cancer experienced some degree of depression, anxiety, and fear, which trigger HPA gland axis and release ISO. ISO recognized and activated their receptorsβ2-AR, and further stimulated VEGF secretion in gastric cancer cells, which subsequently up-regulated plexin-A1 and VEGFR2 expression in both gastric cancer cells and vascular endothelial cells. The expression of plexin-A1 in gastric cancer cells can further influence tumor angiogenesis