Abstract
Gastric cancer was the fifth most common malignancy and the third deadliest cancer (738,000 deaths in 2018) in the world. The analysis of its molecular characteristics has been complicated by histological and intratumor heterogeneity. Furthermore, the previous studies indicate that the incidence of gastric cancer shows wide geographical variation. As the largest and highest region in China, Qinghai-Tibetan Plateau (QTP) is one of the important global biodiversity hotspots. Here, to better understand the mechanism of gastric cancer and offer the targeted therapeutic strategies specially designed for patients in QTP, we collect tumor and blood samples from 30 primary gastric adenocarcinoma cancer patients at Qinghai Provincial People's Hospital. We discuss the clinical and molecular characteristics for these patients that have been ascribed to the unique features in this place, including high altitude (the average height above sea level is around 4,000 m), multi-ethnic groups, and the specific ways of life or habits (such as eating too much beef and mutton, have alcohol and cigarette problem, et al.). By comparing with the western gastric cancer patients collected from TCGA data portal, some unique characteristics for patients in QTP are suggested. They include high incidence in younger people, most of tumor are located in body, most of SNP are detected in chromosome 7, and the very different molecular atlas in minor ethnic groups and Han Chinese. These characteristics will provide the unprecedented opportunity to increase the efficacy for diagnosis and prognosis of gastric cancer in QTP. Furthermore, to suggest the targeted therapeutics specially designed for these 30 patients, an adapted kernel-based learning model and a compilation of pharmacogenomics data of 462 patient-derived tumor cells (PDCs) that illustrate the diverse genetic and molecular backgrounds of cancer patients, were introduced. In conclusion, our study offers a big opportunity to better understand the mechanism of gastric cancer in QTP and guide the optimal patient-tailored therapy for them.
Highlights
It is steadily declining in incidence, cancer of the stomach remains one of the most common and deadly malignancies in the world [1, 2]
For better understanding the mechanism of gastric cancer and offer the targeted therapeutic strategies specially designed for patients in Qinghai-Tibetan Plateau (QTP), we collect tumor and blood sample from 30 primary gastric adenocarcinoma cancer patients at Qinghai Provincial People’s Hospital, and discuss their unique clinical and molecular characteristics that have been ascribed to the unique features in this area
We obtained tumor tissue from 30 primary gastric adenocarcinoma cancer patients not treated with prior chemotherapy or radiotherapy (Table S1)
Summary
It is steadily declining in incidence, cancer of the stomach ( known as gastric cancer) remains one of the most common and deadly malignancies in the world [1, 2]. According to GLOBOCAN 2018 data, gastric cancer is the fifth most common malignancy and the third deadliest cancer (738,000 deaths annually), following only lung and colorectal cancer in overall mortality. Gastric cancer incidence and mortality were used to be related with Helicobacter pylori (H. pylori) infection. Strides in preventing and treating H. pylori infection have already made the incidence declining. Gastric cancer remains the fifth highest incidence among cancers, with 5.7% of all new cases attributable to the disease [3]. Dietary modification, smoking cessation, and exercise hold promise in preventing gastric cancer. East Asia (China and Japan), Eastern Europe, Central and South America are area with high occurrence, and Southern Asia, North and East Africa, North America, Australia, and New Zealand are area with low occurrence [4]
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