Fig. 7. Proposed mechanism for the metastatic tropism of NETs-GC clusters due to postoperative AIC.

Free GC cells from primary GC could develop into CGCs (circulating GC cells) in peripheral blood or DGCs (disseminated GC cells) in abdominal cavity. Once postoperative AIC occur after surgery, pathogens or inflammatory factors would stimulate neutrophils to release NETs not only in peripheral blood but also at infectious sites (abdominal cavity), then in which those NETs trap CGCs or DGCs to form NETs-GC clusters, that potentially facilitate GC cells metastasis.