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T1 Age 2 13 65-year-old T2 Sex 14 17 man T3 Clinical_event 22 30 admitted E1 Clinical_event:T3 T4 Nonbiological_location 38 69 China-Japan Friendship hospital R1 MODIFY Arg1:T4 Arg2:E1 T5 Sign_symptom 108 117 dysphagia E2 Sign_symptom:T5 T6 Duration 122 126 3 mo E3 Duration:T6 T7 Detailed_description 96 107 progressive R2 MODIFY Arg1:T7 Arg2:E2 T8 Sign_symptom 160 171 weight loss E4 Sign_symptom:T8 T9 Lab_value 175 179 8 kg R3 MODIFY Arg1:T9 Arg2:E4 T10 Duration 187 196 past 2 mo E5 Duration:T10 T11 Severity 152 159 drastic R4 MODIFY Arg1:T11 Arg2:E4 T12 History 201 264 denied a history of smoking, alcohol intake and substance abuse T13 History 293 302 gastritis T14 Duration 307 322 nearly 10 years E6 Duration:T14 T15 Disease_disorder 293 302 gastritis E7 Disease_disorder:T15 T16 Detailed_description 284 292 atrophic T17 Detailed_description 276 283 chronic R5 MODIFY Arg1:T16 Arg2:E7 R6 MODIFY Arg1:T17 Arg2:E7 T18 Family_history 340 389 no family history of genetic defect or malignancy T19 Diagnostic_procedure 391 411 Physical examination E8 Diagnostic_procedure:T19 T20 Lab_value 419 439 no palpable findings R7 MODIFY Arg1:T20 Arg2:E8 T21 Diagnostic_procedure 451 461 blood test E9 Diagnostic_procedure:T21 T22 Diagnostic_procedure 490 500 hemoglobin E10 Diagnostic_procedure:T22 T23 Lab_value 471 486 slight decrease R8 MODIFY Arg1:T23 Arg2:E10 R9 SUB_PROCEDURE Arg1:E10 Arg2:E9 T24 Lab_value 502 509 106 g/L R10 MODIFY Arg1:T24 Arg2:E10 T25 Diagnostic_procedure 540 551 examination E11 Diagnostic_procedure:T25 T26 Biological_structure 512 534 Upper gastrointestinal T27 Biological_structure 536 538 GI R11 IDENTICAL Arg1:T27 Arg2:T26 R12 MODIFY Arg1:T26 Arg2:E11 T28 Detailed_description 558 574 barium contrasts R13 MODIFY Arg1:T28 Arg2:E11 T29 Sign_symptom 590 595 tumor E12 Sign_symptom:T29 T30 Severity 584 589 large R14 MODIFY Arg1:T30 Arg2:E12 T31 Sign_symptom 596 604 blocking E13 Sign_symptom:T31 T32 Biological_structure 609 634 esophago-gastric junction R15 MODIFY Arg1:T32 Arg2:E13 R16 CAUSE Arg1:E12 Arg2:E13 T33 Diagnostic_procedure 648 667 Computed tomography E14 Diagnostic_procedure:T33 T34 Diagnostic_procedure 669 671 CT E15 Diagnostic_procedure:T34 R17 IDENTICAL Arg1:E15 Arg2:E14 T35 Sign_symptom 694 698 mass E16 Sign_symptom:T35 T36 Texture 689 693 soft R18 MODIFY Arg1:T36 Arg2:E16 T37 Biological_structure 706 731 esophago-gastric junction R19 MODIFY Arg1:T37 Arg2:E16 T38 Sign_symptom 748 758 metastasis E17 Sign_symptom:T38 T39 Biological_structure 737 747 lymph node R20 MODIFY Arg1:T39 Arg2:E17 T40 Biological_structure 766 797 lesser curvature of the stomach R21 MODIFY Arg1:T40 Arg2:E17 T41 Diagnostic_procedure 811 833 Endoscopic examination E18 Diagnostic_procedure:T41 T42 Sign_symptom 849 853 spot E19 Sign_symptom:T42 T43 Color 843 848 black R22 MODIFY Arg1:T43 Arg2:E19 T44 Biological_structure 861 876 lower esophagus R23 MODIFY Arg1:T44 Arg2:E19 T45 Sign_symptom 895 899 mass E20 Sign_symptom:T45 T46 Color 889 894 black T47 Detailed_description 883 888 bulky R24 MODIFY Arg1:T46 Arg2:E20 R25 MODIFY Arg1:T47 Arg2:E20 T48 Sign_symptom 900 908 blocking E21 Sign_symptom:T48 T49 Biological_structure 913 938 esophago-gastric junction R26 MODIFY Arg1:T49 Arg2:E21 R27 CAUSE Arg1:E20 Arg2:E21 T50 Sign_symptom 973 979 ulcers E22 Sign_symptom:T50 T51 Shape 961 972 crater-like T52 Color 955 960 black T53 Detailed_description 951 954 two R28 MODIFY Arg1:T51 Arg2:E22 R29 MODIFY Arg1:T52 Arg2:E22 R30 MODIFY Arg1:T53 Arg2:E22 T54 Biological_structure 987 1008 fundus of the stomach R31 MODIFY Arg1:T54 Arg2:E22 T55 Diagnostic_procedure 1022 1028 Biopsy E23 Diagnostic_procedure:T55 T56 Sign_symptom 1054 1059 tumor E24 Sign_symptom:T56 R32 MODIFY Arg1:E24 Arg2:E23 T57 Disease_disorder 1101 1115 adenocarcinoma E25 Disease_disorder:T57 T58 Detailed_description 1079 1100 poorly differentiated R33 MODIFY Arg1:T58 Arg2:E25 T59 Diagnostic_procedure 1130 1146 nutrition status E26 Diagnostic_procedure:T59 T60 Lab_value 1171 1172 2 R34 MODIFY Arg1:T60 Arg2:E26 T61 Detailed_description 1186 1215 Nutrition Risk Screening 2002 R35 MODIFY Arg1:T61 Arg2:E26 T62 Coreference 1246 1265 obstructive symptom E27 Coreference:T62 R36 IDENTICAL Arg1:E27 Arg2:E21 T63 Coreference 1280 1285 tumor E28 Coreference:T63 R37 IDENTICAL Arg1:E28 Arg2:E20 T64 Therapeutic_procedure 1289 1306 debulking surgery E29 Therapeutic_procedure:T64 T65 Therapeutic_procedure 1317 1330 esophagectomy E30 Therapeutic_procedure:T65 T66 Therapeutic_procedure 1344 1355 gastrectomy E31 Therapeutic_procedure:T66 T67 Detailed_description 1310 1316 distal R38 MODIFY Arg1:T67 Arg2:E30 T68 Detailed_description 1335 1343 proximal R39 MODIFY Arg1:T68 Arg2:E31 R40 SUB_PROCEDURE Arg1:E30 Arg2:E29 R41 SUB_PROCEDURE Arg1:E31 Arg2:E29 T69 Therapeutic_procedure 1387 1398 anastomosis E32 Therapeutic_procedure:T69 T70 Biological_structure 1371 1386 Esophagogastric R42 MODIFY Arg1:T70 Arg2:E32 T71 Therapeutic_procedure 1403 1417 reconstruction E33 Therapeutic_procedure:T71 T72 Therapeutic_procedure 1442 1457 stapling device E34 Therapeutic_procedure:T72 R43 SUB_PROCEDURE Arg1:E34 Arg2:E33 T73 Sign_symptom 1627 1634 ascites E35 Sign_symptom:T73 A1 POLARITY E35 NEG T74 Sign_symptom 1638 1664 dissemination of the tumor E36 Sign_symptom:T74 A2 POLARITY E36 NEG T75 Biological_structure 1685 1702 peritoneal cavity R44 MODIFY Arg1:T75 Arg2:E36 R45 MODIFY Arg1:T75 Arg2:E35 T76 Sign_symptom 1481 1486 tumor E37 Sign_symptom:T76 T77 Biological_structure 1512 1537 esophago-gastric junction R46 MODIFY Arg1:T77 Arg2:E37 T78 Coreference 1546 1551 tumor E38 Coreference:T78 R47 IDENTICAL Arg1:E38 Arg2:E37 T79 Sign_symptom 1552 1563 infiltrated E39 Sign_symptom:T79 T80 Sign_symptom 1596 1606 metastasis E40 Sign_symptom:T80 T81 Biological_structure 1610 1622 station four #1 AnnotatorNotes T81 lower paratracheal lymph nodes R48 MODIFY Arg1:T81 Arg2:E40 T82 Biological_structure 1585 1595 lymph node R49 MODIFY Arg1:T82 Arg2:E40 T83 Biological_structure 1568 1579 whole layer R50 MODIFY Arg1:T83 Arg2:E39 R51 MODIFY Arg1:E38 Arg2:E39 T84 Sign_symptom 1708 1713 tumor E41 Sign_symptom:T84 T85 Area 1723 1734 3 cm × 6 cm R52 MODIFY Arg1:T85 Arg2:E41 T86 Color 1748 1766 black pigmentation R53 MODIFY Arg1:T86 Arg2:E41 T87 Sign_symptom 1819 1826 nodules E42 Sign_symptom:T87 T88 Color 1799 1808 pigmented T89 Detailed_description 1791 1798 several T90 Detailed_description 1809 1818 satellite R54 MODIFY Arg1:T90 Arg2:E42 R55 MODIFY Arg1:T88 Arg2:E42 R56 MODIFY Arg1:T89 Arg2:E42 T91 Coreference 1838 1855 main tumor lesion E43 Coreference:T91 R57 IDENTICAL Arg1:E43 Arg2:E41 T92 Coreference 1861 1872 largest one E44 Coreference:T92 R58 IDENTICAL Arg1:E44 Arg2:E42 T93 Area 1879 1890 1 cm × 1 cm R59 MODIFY Arg1:T93 Arg2:E44 T94 Sign_symptom 1929 1936 lesions E45 Sign_symptom:T94 T95 Detailed_description 1918 1928 ulceration R60 MODIFY Arg1:T95 Arg2:E45 T96 Biological_structure 1955 1976 fundus of the stomach R61 MODIFY Arg1:T96 Arg2:E45 T97 Diagnostic_procedure 1978 1993 Microscopically E46 Diagnostic_procedure:T97 T98 Biological_structure 2007 2019 tumor tissue R62 MODIFY Arg1:T98 Arg2:E46 T99 Diagnostic_procedure 2143 2167 Pathological examination E47 Diagnostic_procedure:T99 T100 Diagnostic_procedure 2194 2199 stage E48 Diagnostic_procedure:T100 #2 AnnotatorNotes E48 cancer staging T101 Lab_value 2203 2206 IVA T102 Lab_value 2208 2215 T4aN1M0 R63 MODIFY Arg1:T101 Arg2:E48 R64 MODIFY Arg1:T102 Arg2:E48 T103 Diagnostic_procedure 2066 2071 cells E49 Diagnostic_procedure:T103 T104 Lab_value 2054 2065 pleomorphic T105 Lab_value 2036 2049 non-organized T106 Diagnostic_procedure 2092 2098 nuclei E50 Diagnostic_procedure:T106 T107 Lab_value 2083 2091 atypical T108 Diagnostic_procedure 2113 2129 melanin granules E51 Diagnostic_procedure:T108 T109 Lab_value 2104 2112 abundant R65 MODIFY Arg1:T109 Arg2:E51 R66 MODIFY Arg1:T107 Arg2:E50 R67 MODIFY Arg1:T104 Arg2:E49 R68 MODIFY Arg1:T105 Arg2:E49 R69 SUB_PROCEDURE Arg1:E49 Arg2:E46 R70 SUB_PROCEDURE Arg1:E50 Arg2:E49 R71 SUB_PROCEDURE Arg1:E51 Arg2:E49 T110 Diagnostic_procedure 2218 2246 Immunohistochemical staining E52 Diagnostic_procedure:T110 T111 Coreference 2263 2268 tumor E53 Coreference:T111 R72 IDENTICAL Arg1:E53 Arg2:T98 T112 Diagnostic_procedure 2286 2291 S-100 E54 Diagnostic_procedure:T112 T113 Diagnostic_procedure 2293 2299 HMB-45 E55 Diagnostic_procedure:T113 T114 Diagnostic_procedure 2301 2309 mclean-A E56 Diagnostic_procedure:T114 T115 Diagnostic_procedure 2314 2322 Vimentin E57 Diagnostic_procedure:T115 T116 Diagnostic_procedure 2341 2354 cytokeratin 7 E58 Diagnostic_procedure:T116 T117 Diagnostic_procedure 2359 2373 cytokeratin 20 E59 Diagnostic_procedure:T117 T118 Lab_value 2273 2281 positive T119 Lab_value 2328 2336 negative R73 MODIFY Arg1:T118 Arg2:E54 R74 MODIFY Arg1:T118 Arg2:E55 R75 MODIFY Arg1:T118 Arg2:E56 R76 MODIFY Arg1:T118 Arg2:E57 R77 MODIFY Arg1:T119 Arg2:E58 R78 MODIFY Arg1:T119 Arg2:E59 R79 SUB_PROCEDURE Arg1:E54 Arg2:E52 R80 SUB_PROCEDURE Arg1:E55 Arg2:E52 R81 SUB_PROCEDURE Arg1:E56 Arg2:E52 R82 SUB_PROCEDURE Arg1:E57 Arg2:E52 R83 SUB_PROCEDURE Arg1:E58 Arg2:E52 R84 SUB_PROCEDURE Arg1:E59 Arg2:E52 T120 Disease_disorder 2460 2468 melanoma E60 Disease_disorder:T120 T121 Detailed_description 2443 2459 esophago-gastric T122 Severity 2434 2442 advanced T123 Detailed_description 2426 2433 primary R85 MODIFY Arg1:T121 Arg2:E60 R86 MODIFY Arg1:T122 Arg2:E60 R87 MODIFY Arg1:T123 Arg2:E60 T124 Therapeutic_procedure 2490 2510 postoperative course E61 Therapeutic_procedure:T124 T125 Lab_value 2515 2521 smooth R88 MODIFY Arg1:T125 Arg2:E61 T126 Sign_symptom 2534 2547 complications E62 Sign_symptom:T126 A3 POLARITY E62 NEG T127 Sign_symptom 2571 2580 recovered E63 Sign_symptom:T127 T128 Clinical_event 2589 2599 discharged E64 Clinical_event:T128 T129 Date 2600 2610 14 d after E65 Date:T129 T130 Medication 2658 2674 adjuvant therapy E66 Medication:T130 A4 POLARITY E66 NEG T131 Sign_symptom 2686 2696 recurrence E67 Sign_symptom:T131 T132 Biological_structure 2676 2685 abdominal R89 MODIFY Arg1:T132 Arg2:E67 T133 Sign_symptom 2709 2719 metastases E68 Sign_symptom:T133 T134 Biological_structure 2701 2708 hepatic R90 MODIFY Arg1:T134 Arg2:E68 T135 Date 2731 2747 within one month E69 Date:T135 T136 Clinical_event 2767 2776 follow-up E70 Clinical_event:T136 T137 Diagnostic_procedure 2777 2779 CT E71 Diagnostic_procedure:T137 T138 Therapeutic_procedure 2784 2809 other effective treatment E72 Therapeutic_procedure:T138 A5 POLARITY E72 NEG T139 Outcome 2851 2855 died E73 Outcome:T139 T140 Disease_disorder 2867 2885 metastatic disease E74 Disease_disorder:T140 T141 Detailed_description 2859 2866 diffuse R91 MODIFY Arg1:T141 Arg2:E74 T142 Date 2886 2896 2 mo later E75 Date:T142 R92 AFTER Arg1:E1 Arg2:E2 * OVERLAP E2 E3 R93 BEFORE Arg1:E3 Arg2:E4 * OVERLAP E4 E5 R94 AFTER Arg1:E5 Arg2:E7 * OVERLAP E7 E6 R95 BEFORE Arg1:E6 Arg2:E8 * OVERLAP E8 E9 E10 E11 E12 E13 E14 E16 E17 E18 E19 E20 E21 E22 R96 BEFORE Arg1:E22 Arg2:E23 * OVERLAP E23 E25 E26 E27 E28 R97 BEFORE Arg1:E28 Arg2:E29 * OVERLAP E29 E32 E33 E37 E38 E39 E40 E35 E36 E41 E42 E45 E46 E47 E48 E52 E60 R98 BEFORE Arg1:E60 Arg2:E61 * OVERLAP E61 E62 R99 BEFORE Arg1:E62 Arg2:E63 R100 BEFORE Arg1:E63 Arg2:E64 * OVERLAP E64 E65 R101 BEFORE Arg1:E65 Arg2:E66 * OVERLAP E66 E67 E68 E69 E70 E71 R102 BEFORE Arg1:E71 Arg2:E72 R103 BEFORE Arg1:E72 Arg2:E73 * OVERLAP E73 E74 E75