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T1 Age 2 13 70-year-old T2 Sex 14 17 man T3 Clinical_event 22 30 referred E1 Clinical_event:T3 T4 Nonbiological_location 38 46 hospital T5 Biological_structure 51 58 gastric T6 Disease_disorder 59 65 cancer E2 Disease_disorder:T6 R1 MODIFY Arg1:T5 Arg2:E2 T7 Diagnostic_procedure 104 130 esophagogastroduodenoscopy E3 Diagnostic_procedure:T7 T8 Diagnostic_procedure 131 136 (EGD) E4 Diagnostic_procedure:T8 R2 IDENTICAL Arg1:E4 Arg2:E3 T9 History 138 168 No significant medical history T10 Sign_symptom 192 199 dysuria E5 Sign_symptom:T10 T11 Detailed_description 200 229 caused by bladder contraction R3 MODIFY Arg1:T11 Arg2:E5 T12 Diagnostic_procedure 239 249 laboratory E6 Diagnostic_procedure:T12 T13 Diagnostic_procedure 264 282 serum level of AFP E7 Diagnostic_procedure:T13 T14 Lab_value 286 296 32.3 ng/mL R4 MODIFY Arg1:T14 Arg2:E7 R5 SUB_PROCEDURE Arg1:E7 Arg2:E6 T15 Diagnostic_procedure 396 420 carcinoembryonic antigen E8 Diagnostic_procedure:T15 T16 Diagnostic_procedure 421 426 (CEA) E9 Diagnostic_procedure:T16 T17 Diagnostic_procedure 431 456 carbohydrate antigen 19-9 E10 Diagnostic_procedure:T17 T18 Diagnostic_procedure 457 465 (CA19-9) E11 Diagnostic_procedure:T18 R6 IDENTICAL Arg1:E11 Arg2:E10 R7 IDENTICAL Arg1:E9 Arg2:E8 R8 SUB_PROCEDURE Arg1:E8 Arg2:E6 R9 SUB_PROCEDURE Arg1:E10 Arg2:E6 T19 Lab_value 329 349 no other abnormality R10 MODIFY Arg1:T19 Arg2:E8 R11 MODIFY Arg1:T19 Arg2:E10 T20 Coreference 467 470 EGD E12 Coreference:T20 R12 IDENTICAL Arg1:E12 Arg2:E3 T21 Sign_symptom 503 507 mass E13 Sign_symptom:T21 T22 Detailed_description 487 502 ulcerofungating R13 MODIFY Arg1:T22 Arg2:E13 T23 Distance 482 486 5-cm R14 MODIFY Arg1:T23 Arg2:E13 T24 Detailed_description 517 550 comprised of three septate ulcers R15 MODIFY Arg1:T24 Arg2:E13 T25 Biological_structure 551 597 in the greater curvature of the gastric antrum R16 MODIFY Arg1:T25 Arg2:E13 T26 Diagnostic_procedure 601 625 pathological examination E14 Diagnostic_procedure:T26 T27 Biological_structure 629 654 endoscopic biopsy tissues T28 Disease_disorder 715 729 adenocarcinoma E15 Disease_disorder:T28 T29 Detailed_description 707 714 tubular R17 MODIFY Arg1:T29 Arg2:E15 T30 Detailed_description 681 706 moderately differentiated R18 MODIFY Arg1:T30 Arg2:E15 R19 MODIFY Arg1:T27 Arg2:E14 R20 MODIFY Arg1:E15 Arg2:E14 T31 Diagnostic_procedure 757 776 computed tomography E16 Diagnostic_procedure:T31 T32 Biological_structure 742 756 abdominopelvic R21 MODIFY Arg1:T32 Arg2:E16 T33 Sign_symptom 798 802 mass E17 Sign_symptom:T33 T34 Biological_structure 790 797 gastric R22 MODIFY Arg1:T34 Arg2:E17 R23 MODIFY Arg1:E17 Arg2:E16 T35 Detailed_description 803 823 with deep ulceration R24 MODIFY Arg1:T35 Arg2:E17 T36 Biological_structure 824 845 in the gastric antrum R25 MODIFY Arg1:T36 Arg2:E17 T37 Detailed_description 846 885 with perigastric lymph node enlargement R26 MODIFY Arg1:T37 Arg2:E17 T38 Sign_symptom 890 908 metastatic lesions E18 Sign_symptom:T38 A1 POLARITY E18 NEG T39 Biological_structure 930 935 liver T40 Biological_structure 937 941 lung T41 Biological_structure 945 955 peritoneum R27 MODIFY Arg1:T39 Arg2:E18 R28 MODIFY Arg1:T40 Arg2:E18 R29 MODIFY Arg1:T41 Arg2:E18 T42 Biological_structure 961 966 chest T43 Diagnostic_procedure 967 978 radiography E19 Diagnostic_procedure:T43 R30 MODIFY Arg1:T42 Arg2:E19 T44 Sign_symptom 986 1009 no significant findings E20 Sign_symptom:T44 R31 MODIFY Arg1:E20 Arg2:E19 T45 Therapeutic_procedure 1028 1039 gastrectomy E21 Therapeutic_procedure:T45 T46 Detailed_description 1011 1018 Radical T47 Detailed_description 1019 1027 subtotal R32 MODIFY Arg1:T47 Arg2:E21 R33 MODIFY Arg1:T46 Arg2:E21 T48 Biological_structure 1045 1058 D2 lymph node T49 Therapeutic_procedure 1059 1069 dissection E22 Therapeutic_procedure:T49 T50 Therapeutic_procedure 1086 1103 gastrojejunostomy E23 Therapeutic_procedure:T50 T51 Detailed_description 1074 1085 Billroth II R34 MODIFY Arg1:T48 Arg2:E22 R35 MODIFY Arg1:T51 Arg2:E23 R36 SUB_PROCEDURE Arg1:E22 Arg2:E21 R37 SUB_PROCEDURE Arg1:E23 Arg2:E21 T52 Therapeutic_procedure 2366 2386 postoperative course E24 Therapeutic_procedure:T52 T53 Lab_value 2355 2365 uneventful R38 MODIFY Arg1:T53 Arg2:E24 T54 Clinical_event 2395 2405 discharged E25 Clinical_event:T54 T55 Date 2409 2428 postoperative day 9 E26 Date:T55 T56 Date 2430 2445 Two weeks later E27 Date:T56 T57 Diagnostic_procedure 2451 2460 HCG level E28 Diagnostic_procedure:T57 T58 Lab_value 2465 2475 176 mIU/mL R39 MODIFY Arg1:T58 Arg2:E28 T59 Diagnostic_procedure 2512 2521 AFP level E29 Diagnostic_procedure:T59 T60 Lab_value 2526 2536 10.0 ng/mL R40 MODIFY Arg1:T60 Arg2:E29 T61 Medication 2552 2573 adjuvant chemotherapy E30 Medication:T61 T62 Medication 2579 2591 capecitabine E31 Medication:T62 R41 MODIFY Arg1:E31 Arg2:E30 T63 Frequency 2538 2548 Six cycles R42 MODIFY Arg1:T63 Arg2:E30 T64 Dosage 2657 2690 2500 mg/m2 per day for 14 d/cycle R43 MODIFY Arg1:T64 Arg2:E31 T65 Date 2692 2708 After two cycles E32 Date:T65 T66 Diagnostic_procedure 2714 2725 β-HCG level E33 Diagnostic_procedure:T66 T67 Lab_value 2742 2752 < 3 mIU/mL R44 MODIFY Arg1:T67 Arg2:E33 T68 Sign_symptom 2795 2805 recurrence E34 Sign_symptom:T68 T69 Sign_symptom 2809 2827 distant metastasis E35 Sign_symptom:T69 T70 Date 2848 2854 4-year E36 Date:T70 T71 Clinical_event 2855 2878 postoperative follow-up E37 Clinical_event:T71 T72 Biological_structure 1133 1150 resected specimen T73 Sign_symptom 1168 1175 lesions E38 Sign_symptom:T73 T74 Lab_value 1161 1167 double R45 MODIFY Arg1:T74 Arg2:E38 T75 Detailed_description 1191 1243 a 5.8 cm × 3.2 cm ulcerofungating mass in the antrum T76 Detailed_description 1250 1270 extensive hemorrhage R46 MODIFY Arg1:T75 Arg2:E38 R47 MODIFY Arg1:T76 Arg2:E38 T77 Detailed_description 1286 1294 fibrosis R48 MODIFY Arg1:T77 Arg2:E38 T78 Color 1275 1285 light gray R49 MODIFY Arg1:T78 Arg2:T77 T79 Detailed_description 1315 1357 a nearby 2.5 cm × 2.0 cm ulcerative lesion R50 MODIFY Arg1:T79 Arg2:E38 T80 Sign_symptom 1428 1439 tumor cells E39 Sign_symptom:T80 T81 Detailed_description 1420 1427 bizarre T82 Detailed_description 1407 1418 pleomorphic T83 Lab_value 1388 1403 massive numbers R51 MODIFY Arg1:T83 Arg2:E39 R52 MODIFY Arg1:T81 Arg2:E39 R53 MODIFY Arg1:T82 Arg2:E39 T84 Detailed_description 1445 1499 hemorrhage (syncytiotrophoblasts and cytotrophoblasts) R54 MODIFY Arg1:T84 Arg2:E39 T85 Diagnostic_procedure 1535 1577 Hematoxylin and eosin (HE)-stained tissues E40 Diagnostic_procedure:T85 T86 Biological_structure 1603 1612 cytoplasm T87 Color 1596 1602 purple T88 Shape 1589 1595 bubbly R55 MODIFY Arg1:T87 Arg2:T86 R56 MODIFY Arg1:T88 Arg2:T86 T89 Biological_structure 1623 1629 nuclei T90 Detailed_description 1635 1656 magnification of 40 × T91 Detailed_description 1674 1679 100 × R57 MODIFY Arg1:T90 Arg2:E40 R58 MODIFY Arg1:T91 Arg2:E40 R59 MODIFY Arg1:T86 Arg2:E40 R60 MODIFY Arg1:T89 Arg2:E40 T92 Lab_value 1617 1622 giant R61 MODIFY Arg1:T92 Arg2:T89 T93 Coreference 1698 1703 tumor E41 Coreference:T93 R62 IDENTICAL Arg1:E41 Arg2:E39 T94 Biological_structure 1717 1742 proper muscle layer (T2a) R63 MODIFY Arg1:T94 Arg2:E41 T95 Sign_symptom 1747 1757 metastasis E42 Sign_symptom:T95 T96 Biological_structure 1768 1802 in four of 56 regional lymph nodes R64 MODIFY Arg1:T96 Arg2:E42 T97 Diagnostic_procedure 1809 1837 Immunohistochemical staining E43 Diagnostic_procedure:T97 T98 Lab_value 1845 1870 positive immunoreactivity T99 Diagnostic_procedure 1875 1905 β-human chorionic gonadotropin E44 Diagnostic_procedure:T99 T100 Diagnostic_procedure 1950 1953 AFP E45 Diagnostic_procedure:T100 T101 Lab_value 1929 1945 focal positivity R65 MODIFY Arg1:T101 Arg2:E45 R66 MODIFY Arg1:T98 Arg2:E44 R67 SUB_PROCEDURE Arg1:E44 Arg2:E43 R68 SUB_PROCEDURE Arg1:E45 Arg2:E43 T102 Disease_disorder 2017 2032 choriocarcinoma E46 Disease_disorder:T102 T103 Biological_structure 2009 2016 gastric R69 MODIFY Arg1:T103 Arg2:E46 T104 Disease_disorder 2151 2165 adenocarcinoma E47 Disease_disorder:T104 T105 Biological_structure 2143 2150 tubular T106 Disease_disorder 2079 2093 adenocarcinoma E48 Disease_disorder:T106 T107 Detailed_description 2065 2078 AFP-producing R70 MODIFY Arg1:T107 Arg2:E48 R71 MODIFY Arg1:T105 Arg2:E47 T108 Biological_structure 2173 2205 extended to the submucosal layer R72 MODIFY Arg1:T108 Arg2:E47 R73 MODIFY Arg1:T4 Arg2:E1 * OVERLAP E1 E2 E3 R74 AFTER Arg1:E3 Arg2:E5 R75 BEFORE Arg1:E5 Arg2:E6 * OVERLAP E6 E12 E13 E14 E15 R76 BEFORE Arg1:E15 Arg2:E16 * OVERLAP E16 E17 E18 E19 E20 R77 BEFORE Arg1:E20 Arg2:E21 R78 BEFORE Arg1:E21 Arg2:E38 R79 MODIFY Arg1:T72 Arg2:E38 * OVERLAP E38 E39 E40 E42 E41 E43 E46 E48 E47 R80 BEFORE Arg1:E47 Arg2:E24 R81 BEFORE Arg1:E24 Arg2:E25 * OVERLAP E25 E26 R82 BEFORE Arg1:E26 Arg2:E27 * OVERLAP E27 E28 E29 R83 BEFORE Arg1:E29 Arg2:E30 R84 BEFORE Arg1:E30 Arg2:E32 * OVERLAP E32 E33 R85 BEFORE Arg1:E33 Arg2:E34 A2 POLARITY E34 NEG A3 POLARITY E35 NEG * OVERLAP E34 E35 E36 E37 T109 Lab_value 2730 2738 declined E49 Lab_value:T109 R86 MODIFY Arg1:E49 Arg2:E33