Cardia Gastric Cancer Is Associated With Increased PIK3CA Amplifications and HER2 Expression Than Noncardia Gastric Cancer According to Lauren Classification.

Yi-Ming Shyr,Shih-Min Pai,Yee Chao,Kuo-Hung Huang,Wen-Liang Fang,Ming-Huang Chen,Anna Fen-Yau Li,Su-Shun Lo,Chew-Wun Wu

doi:10.3389/fonc.2021.632609

Yi-Ming Shyr, Shih-Min Pai + Show 7 more

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https://doi.org/10.3389/fonc.2021.632609

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Abstract

BackgroundTo date, few reports have investigated genetic alterations and clinicopathological features in cardia and noncardia gastric cancer (GC).MethodsIn total, 435 GC patients receiving curative surgery were included. The clinicopathological features, recurrence patterns, prognoses and genetic alterations were compared between cardia and noncardia GC patients.ResultsAmong the 435 enrolled patients, 47 (10.8%) had cardia GC. Compared with noncardia GC, cardia GC was associated with more intestinal-type tumors and similar initial recurrence patterns and 5-year overall survival (OS; 50.8% vs. 50.5%, P = 0.480) and disease-free survival (DFS; 48.6% vs. 48.9%, P = 0.392) rates. For both intestinal-type GC and diffuse-type GC, the clinicopathological features and 5-year OS and DFS rates were not significantly different between the cardia and noncardia GC patients. Multivariable analysis showed that cardia GC was not an independent prognostic factor. Compared with noncardia GC, cardia GC was associated with increased PIK3CA amplification than in patients with intestinal-type GC and was associated with increased HER2 expression in patients with diffuse-type GC.ConclusionsCardia GC is not an independent prognostic factor. In cardia GC patients with intestinal-type GC, PIK3CA amplification was more common, and in those with diffuse-type GC, HER2 expression was more common. Targeted therapy may be beneficial for these patient subgroups.

Highlights

Gastric cancer (GC) is the sixth most common cancer and ranks second in terms of cancer-related death worldwide [1]
Genome-wide association studies have revealed that some single nucleotide polymorphisms (SNPs) are associated with noncardia GC only [4], while others have shown no difference in the Single nucleotide polymorphism (SNP) between cardia and noncardia GC [5]
The correlation between HER2 expression and histologic types in GC is controversial; HER2 expression has been reported to be associated with intestinaltype GC in some studies [7], whereas other studies have indicated that HER2 expression was more common in diffusetype GC [8]

Summary

Introduction

Gastric cancer (GC) is the sixth most common cancer and ranks second in terms of cancer-related death worldwide [1]. It was reported that cardia GC was associated with more advanced staging and unfavorable clinicopathological features at diagnosis than noncardia GC [3]. In terms of molecular analyses, some reports have investigated genetic alterations in cardia and noncardia GC [4, 5]. The correlation between HER2 expression and histologic types in GC is controversial; HER2 expression has been reported to be associated with intestinaltype GC in some studies [7], whereas other studies have indicated that HER2 expression was more common in diffusetype GC [8]. There is a need to investigate the correlation between genetic alterations and histologic type in cardia and noncardia GC. Few reports have investigated genetic alterations and clinicopathological features in cardia and noncardia gastric cancer (GC)

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