Lymphovascular invasion (LVI) in gastric cancer is readily demonstrated pre-operatively by mucosal biopsy during endoscopy, which can also provide samples for gene expression profiling. We have examined gene expression associated with lymphovascular invasion in a cohort of gastric cancer patients and have developed a 28-gene predictor of tumor aggressiveness for forecasting risk of node positivity (N+), which could potentially be useful pre-operatively. The resulting model's ranking of increasing tumor aggressiveness correlated positively with N+ status, reaching statistical significance, and was three times the correlation of LVI with N+ status.