Abstract
Gastric cardiac carcinoma demonstrates much more complex molecular pathobiology than esophageal or distal gastric non-cardiac carcinomas. The most common molecular type is the chromosomal instable carcinoma that shows an increasing gradient from a low prevalence in the distal stomach to a high level in the gastric cardia and to the peak in the distal esophagus. Thus, esophageal adenocarcinoma is in fact part of gastric chromosomal instable carcinoma. In contrast, Epstein-Barr virus-related, microsatellite instable, and genomic stable carcinomas occur in gastric cardiac carcinoma, but not so or extremely rare in esophageal adenocarcinoma. The most important molecular target in gastric cardiac carcinoma is the HER2 gene, in addition to PD-1 and PD-L1, with significant therapeutic values to treat patients with advanced gastric cardiac carcinoma.
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