Histological Type Of Gastric Cancer Research Articles

Prognostic significance of connective tissue growth factor expression in stromal cells in patients with diffuse‑type gastric cancer.

Connective tissue growth factor (CTGF) is a target gene of the Hippo signaling pathway. Its differential role in the histological types of gastric cancer (GC) remains unknown; therefore, the present study aimed to confirm the clinical significance of CTGF expression in cancer and stromal cells in patients with GC depending on the histological type. The present study enrolled 589 patients with GC. Immunohistochemistry was used to analyze CTGF expression in cancer and stromal cells. CTGF mRNA expression data and the corresponding clinical information of GC samples were collected from The Cancer Genome Atlas (TCGA) database. Subsequently, the associations between CTGF expression and several clinicopathological factors were investigated. In the present study, CTGF expression was mainly observed in the cytoplasm of cancer and stromal cells. CTGF expression in stromal cells was significantly associated with CTGF expression in cancer cells (P<0.001). CTGF positivity in stromal cells was also significantly associated with intestinal type, non-scirrhous type, tumor depth (T1-2), lymph node metastasis (negative), lymphatic invasion (negative) and tumor size (<5 cm). Low CTGF expression in stromal cells was independently associated with worse overall survival (OS). Furthermore, the OS of patients with low CTGF expression in stromal cells, especially in patients with diffuse-type GC, was significantly worse than patients with high CTGF expression (P=0.022). This trend was similar to that revealed by TCGA data analysis. In conclusion, low CTGF expression was associated with a significantly worse OS in patients with diffuse-type GC. These data indicated that CTGF, and its control by the Hippo pathway, may be considered potential treatment targets in diffuse-type GC.

Early-onset gasrtric cancer (review)

Objective. Early-onset gastric cancer (EOGC) constitutes a serious medical and social problem. Early-onset gastric cancer accounts for approximately 6% of all malignant epithelial neoplasms.Material and Methods. We reviewed retrospective and prospective randomized trials using Medline and Elibrary databases.Results. The applied significance of the molecular genetic classifications consist in the formation of groups for evaluating prognosis of the disease using multifactorial analysis. This classification indicates that EOGC diagnosed at a locally advanced stage and primary dissemination is most often caused by GS (TCGA) and MSS/EMT(ACRG) subtypes and is characterized by mutations in CDH1, RhoA, CLDN18-ARHGAP genes. These changes are accompanied by the prevalence of diffuse histological type of gastric cancer according to the Lauren classification and ulcerated or infiltrative type according to the Borrmann classification (type III and IV) with the presence of high-grade adenocarcinoma with a signet ring cell component.Conclusion. Considering the aggressiveness of gastric cancer in young patients, who more frequently present with locally advanced and metastatic disease at the time of diagnosis, there is a need for increased cancer alertness among physicians of other specialties, early endoscopic controls to detect cancer at early stages and benefit from both surgical and multimodal treatment.

Cardiac tamponade due to advanced gastric cancer: a pathomorphological systematic review of clinical cases

Annotation. Pericardial involvement due to gastric cancer is uncommon, especially when it’s secondary to direct transdiaphragmatic tumor infiltration, and its manifestation in the form of cardiac tamponade is an exceptional situation. The aim of this review is to provide a pathomorphological overview of three rare clinical cases of cardiac tamponade, which was the first clinical manifestation of advanced gastric cancer. To realize the goal, a meta-analysis of 15 publications included in the Medline and Scopus scientific databases was conducted. The statistical substantiation of the research was carried out using Microsoft Excel 2016 and Statistica 12.0. According to the results of histological analysis, these three cases of gastric cancer were classified as: poorly differentiated adenocarcinoma of the antrum in a 52-year-old patient; sarcomatoid carcinoma of the fundus in a 49-year-old patient; and scirrhous carcinoma of the fundus in a 70-year-old patient. The tropism of gastric tumor infiltration into the pericardium is substantiated with the help of transforming growth factor, which increases the expression of CD44 adhesion molecules in tumor cells and stimulates the ability of the tumor to infiltrate the pericardium due to adhesion to the mesothelium. The hepatocyte growth factor, which enhances the invasive properties of the tumor, also played an important role: the C-Met receptors were determined on tumor cells in all cases. Thus, cardiac tamponade, which is a terminal condition, can occur in patients with various histological types of gastric cancer, including the three described. Furthermore, in the medical literature this over review is probably the only one attempt to analyze cardiac tamponade due to advanced gastric cancer with a comparison of different clinical cases.

Immune regulation in gastric adenocarcinoma is linked with therapeutic efficacy and improved recovery.

Adenocarcinomas are one of the most common histological types of gastric cancer. It has been ranked fifth among common cancers and is the third among death causing cancers worldwide. The high mortality rate among patients with gastric cancer is because of its silent evolution, genetic heterogeneity, high resistance to chemotherapy as well as unavailability of highly effective therapeutic strategy. Until now a number of several treatment strategies have been developed and are being practiced such as surgery, chemotherapy, radio therapy, and immunotherapy, however, further developments are required to improve the treatment responses and reduce the side effects. Therefore, novel personal therapeutic strategies based on immunological responses should be developed by targeting different check points and key immune players. Targeting macrophages and related molecular elements can be useful to achieve these goals. In this minireview, we discuss the available treatment options, molecular underpinnings and immunological regulations associated with gastric adenocarcinoma. We further describe the possible check points and immunological targets that can be used to develop novel therapeutic options.

Clinical significance of CD166 and HER-2 in different types of gastric cancer.

Cluster of differentiation 166 (CD166), a cancer stem cell (CSC) marker, and human epidermal growth factor receptor 2 (HER-2) are expressed in a diversity of malignancies and is associated with tumor progression. Although studies regarding the importance of CSC markers and HER-2 in gastric cancer (GC) have rapidly developed, their clinicopathological, prognosis, and diagnosis value still remain unsatisfying in GC. Therefore, the present study aims to investigate the clinical, prognostic, and diagnostic significance of CD166 and HER-2 in different histological types of GC. Bioinformatic analysis was applied to determine the clinical importance of CD166 and HER-2 expression based on their tissue localization in primary GC tumors and the normal adjacent samples. The expression patterns, clinical significance, prognosis, and diagnosis value of CD166 and HER-2 proteins in tissue microarrays (TMAs) of 206 GC samples, including Signet Ring Cell (SRC) and intestinal types and also 28 adjacent normal tissues were evaluated using immunohistochemistry (IHC). The results indicated that the expression of CD166 (membranous and cytoplasmic) and HER-2 were significantly up-regulated in tumor cells compared to adjacent normal tissues (P = 0.010, P < 0.001, and P = 0.011, respectively). A statistically significant association was detected between a high level of membranous expression of CD166 and lymphovascular invasion (P = 0.006); We also observed a statistically significant association between high cytoplasmic expression of CD166 protein and more invasion of the subserosa (P = 0.040) in the SRC type. In contrast, there was no correlation between the expression of HER-2 and clinicopathologic characteristics. Both CD166 and HER-2 showed reasonable accuracy and high specificity as diagnostic markers. Our results confirmed that increased membranous and cytoplasmic expression of CD166 showed clinical significance in the SRC type and is associated with the progression of the disease and more aggressive tumor behaviors. These findings can be used to assist in designating subgroups of patients that require different follow-up strategies, and also, they might be utilized as the prognostic or diagnostic biomarkers in these types of GC for prospective clinical application.

Transcriptome sequencing and miRNA-mRNA network construction in exosome of macrophage M2 in stomach adenocarcinoma

BackgroundStomach adenocarcinoma (STAD) is the most common histological type of gastric cancer (GC). Macrophages are an essential part of the tumor microenvironment. We attempted to search for potential molecular markers associated with macrophages, which might be helpful for STAD diagnosis and treatment.MethodsFirstly, exosome in macrophages was extracted for RNA sequencing to identify differentially expressed microRNAs (miRNAs) (DEmiRNAs). Then, DEmiRNAs and differentially expressed mRNAs (DEmRNAs) were screened in the Cancer Genome Atlas (TCGA) database. The miRNAs related to macrophage M2 polarization were obtained by intersecting the DEmiRNAs obtained from the sequencing data and TCGA data. Using the Pearson correlation coefficient method, the mRNAs significantly related to macrophage M2 were screened out, followed by construction of the macrophage M2-miRNA-mRNA network. Subsequently, real-time-polymerase chain reaction (RT-PCR) and online datasets were applied to validate the expression of DEmiRNAs and DEmRNAs.ResultsA total of 6 DEmiRNAs were identified in RNA sequencing; 59 DEmiRNAs and 1838 DEmRNAs were identified in TCGA database. Among which, a common miRNA (hsa-miR-133a-3p) associated with the M2 polarization of macrophages was identified. Fifteen common mRNAs were obtained between DEmRNAs and mRNAs targeted by DEmiRNAs. Eventually, a core macrophage M2-1 down-regulated miRNA-7 and up-regulated mRNAs network was constructed, including hsa-miR-133a-3p, SLC39A1, TTYH3, HAVCR2, TPM3, XPO1, POU2F1, and MMP14. The expression of miRNA and mRNAs was in line with the validation results of RT-PCR and online datasets.ConclusionIn this study, the screening of biomarkers in exosome of macrophage M2 may contribute to the prognosis of STAD patients.

Gastric Cancer: Correlation of Histologic Type with Commonly Used Prognostic Variables

Background: Gastric cancer is one of the most common cancers among Iranian men and women. Objectives: The aim here was to investigate different histopathologic types and features of this cancer in association with selected prognostic variables. Methods: A retrospective cross-sectional study was performed to reevaluate the pathologic samples of 100 cases of gastric cancer referred to Shohadaye Tajrish Hospital, Tehran, Iran from 2017 to 2022. Results: We evaluated 100 cases of gastric cancer in this study. They had a mean age of 62.4 ± 13.44 years old (range 28 - 84 years) and were mostly men (n = 66, 66 %). On histopathologic evaluation, tubular carcinoma was the most common type (n = 45, 45%). We found a statistically significant correlation between the histologic type and perineural invasion (P-value = 0.024), lymphovascular invasion (P-value &lt; 0.001), tumoral involvement of surgical margin (P-value = 0.012 ), infiltration depth of the primary tumor (pT) (P-value = 0.049) , number of metastatic lymph nodes (pN) (P-value = &lt; 0.001) , tumor location in the antrum (P-value=0.033) and body (P-value = 0.013) , and tumor size (P-value = 0.002 and P-value = 0.031 in small and large size groups respectively). Conclusions: According to the findings, histologic type of gastric cancer correlates with perineural invasion, lymphovascular invasion, tumoral involvement of the surgical margin, pT, pN, and tumor location and size.

Multilevel proteomic analyses reveal molecular diversity between diffuse-type and intestinal-type gastric cancer

Diffuse-type gastric cancer (DGC) and intestinal-type gastric cancer (IGC) are the major histological types of gastric cancer (GC). The molecular mechanism underlying DGC and IGC differences are poorly understood. In this research, we carry out multilevel proteomic analyses, including proteome, phospho-proteome, and transcription factor (TF) activity profiles, of 196 cases covering DGC and IGC in Chinese patients. Integrative proteogenomic analysis reveals ARIDIA mutation associated with opposite prognostic effects between DGC and IGC, via diverse influences on their corresponding proteomes. Systematical comparison and consensus clustering analysis identify three subtypes of DGC and IGC, respectively, based on distinct patterns of the cell cycle, extracellular matrix organization, and immune response-related proteins expression. TF activity-based subtypes demonstrate that the disease progressions of DGC and IGC were regulated by SWI/SNF and NFKB complexes. Furthermore, inferred immune cell infiltration and immune clustering show Th1/Th2 ratio is an indicator for immunotherapeutic effectiveness, which is validated in an independent GC anti-PD1 therapeutic patient group. Our multilevel proteomic analyses enable a more comprehensive understanding of GC and can further advance the precision medicine.

The value of CT-based radiomics nomogram in differential diagnosis of different histological types of gastric cancer

To establish and verify a nomogram based on computed tomography (CT) radiomics analysis to predict the histological types of gastric cancer preoperatively for patients with surgical indications. A sum of 171 patients with gastric cancer were included into this retrospective study. The least absolute shrinkage and selection operator (LASSO) was used for feature selection while the multivariate Logistic regression method was used for radiomics model and nomogram building. The area under curve (AUC) was used for performance evaluation in this study. The radiomics model got AUCs of 0.755 (95% CI 0.650–0.859), 0.71 (95% CI 0.543–0.875) and 0.712 (95% CI 0.500–0.923) for histological prediction in the training, the internal and external verification cohorts. The radiomics nomogram based on radiomics features and Carbohydrate antigen 125 (CA125) showed good discriminant performance in the training cohort (AUC: 0.777; 95% CI 0.679–0.875), the internal (AUC: 0.726; 95% CI 0.5591–0.8933) and external verification cohort (AUC: 0.720; 95% CI 0.5036–0.9358). The calibration curve of the radiomics nomogram also showed good results. The decision curve analysis (DCA) shows that the radiomics nomogram is clinically practical. The radiomics nomogram established and verified in this study showed good performance for the preoperative histological prediction of gastric cancer, which might contribute to the formulation of a better clinical treatment plan.

Clinicopathological Features and Postoperative Survival Analysis of Gastric Carcinoma with Neuroendocrine Differentiation

Objectives This study aims at investigating the differences of clinicopathological features and postoperative prognosis in three different types of neuroendocrine differentiation-related gastric cancers. Methods From January 1, 2015 to September 30, 2016, 47 patients diagnosed with neuroendocrine differentiation-related gastric cancers were collected from 1095 patients with gastric cancer who underwent surgical treatment in the Department of Gastrointestinal Surgery, Jiangsu Cancer Hospital. Patients were followed up regularly, and the last follow-up time was October 25, 2021. A total of 38 cases met the inclusion criteria and completed follow-up. The clinicopathological characters and immunohistochemical results of these three special pathological types of gastric cancer (adenocarcinoma with neuroendocrine differentiation, mixed adenoneuroendocrine carcinoma, and neuroendocrine carcinoma of the stomach) patients were compared. Tissues from these patients were tested with immunohistochemical markers synaptophysin (Syn), chromogranin A (CgA), and Ki-67. The Kaplan–Meier method and log-rank test were used to analyze the effect of different histological types of gastric cancer on overall survival (OS). The differences in positive rates of chromogranin A (CgA) and Ki-67 were analyzed by univariate Cox regression analysis as independent risk factors that may affect the survival of gastric cancer patients. Results Ki-67 and N staging were significantly correlated with OS in gastric cancer patients and were independent prognostic factors affecting the survival of gastric cancer patients. There was no statistical difference in OS between the two histopathological types (adenocarcinoma with neuroendocrine differentiation and mixed adenoneuroendocrine carcinoma) of gastric cancer patients. There were no significant differences in the positive rates of immunohistochemical markers Syn, CgA, and Ki-67 in gastric cancer patients with different histological types. Conclusion The combined detection of Syn and CgA is of great value for the diagnosis of neuroendocrine differentiation-related gastric cancers, Ki-67 is of significance for the prognosis prediction of neuroendocrine differentiation-related gastric cancers, regional lymph node metastasis has a great impact on tumor prognosis, and the N staging determines the necessity of postoperative adjuvant chemotherapy for patients with neuroendocrine differentiation-related gastric cancer.

Identification of 8-gene risk prediction signature associated with NOTCH1 in stomach adenocarcinoma based on bioinformatics analysis.

BackgroundStomach adenocarcinoma (STAD), is the most common histological type of gastric cancer (GC) with high mortality and poor prognosis. We sought to investigate the contribution of Notch receptor 1 (NOTCH1) to STAD immunity.MethodsThe profiles of immune cells in STAD cohorts were compared, and a correlation analysis between the NOTCH1 gene and tumor immune cell infiltration was then conducted. The immune-related genes (IRGs) associated with the NOTCH1 gene were identified. Based on the NOTCH1-associated IRGs, multiple-gene risk prediction signatures were established. The relationship between the expression levels of the selected IRGs and overall survival (OS) was analyzed by a univariate analysis. The risk score was calculated using the formula of β1x1 + β2x2 +... + βixi. A prognostic nomogram was constructed to predict individuals’ survival probabilities.ResultsIn STAD, NOTCH1 expression levels were significantly negatively associated with tumor-infiltrating lymphocyte (TIL) Act dendritic cells (DCs) (r=−0.196, P value =6.24e-05), TIL cluster of differentiation (CD) 56 bright cells (r=−0.115, P value =0.0193), TIL immature DCs (r=−0.293, P value =1.16e-09), TIL monocyte cells (r=−0.185, P value =0.000149), TIL central memory T CD4 cells (r=−0.126, P value =0.0103), and TIL gamma delta T cells (r=−0.149, P value =0.00229). The resulting risk scores of the 8-gene risk prediction signature (corticotrophin releasing hormone receptor 2 (CRHR2) (HR =1.858, P value =0.048), fms related receptor tyrosine kinase 1 (FLT1) (HR =1.268, P value =0.048), fms related receptor tyrosine kinase 4 (FLT4) (HR =1.334, P value =0.031), glial fibrillary acidic protein (GFAP) (HR =2.739, P value =0.008), platelet-derived growth factor receptor beta (PDGFRB) (HR =1.192, P value =0.02), prostaglandin D2 receptor (PTGDR) (HR =1.564, P value =0.049), semaphorin 5B (SEMA5B) (HR =1.154, P value =0.029), and tyrosine kinase 2 (TYK2) (HR =0.734, P value =0.041) were independent prognostic predictors for STAD patients.ConclusionsNOTCH1 could be a potential target for STAD. The mechanisms underpinning NOTCH1-medicated prognostic values of immune signatures should be further explored.

Gastric Signet Ring Cell Carcinoma: An Overview

Gastric signet ring cell carcinoma (GSRCC) is an important histological type of gastric cancer. Its biological and clinical particularities distinguish it from other gastric cancers in ways that require tailored clinical management and decision-making. This short review provides an overview of what is known about this prevalent clinical entity, highlights recent developments in the research surrounding GSRCC, and covers microbiome, immunology, computational pathology, and clinical research findings.

Integrated Bioinformatics Analysis for Identifying the Significant Genes as Poor Prognostic Markers in Gastric Adenocarcinoma.

Gastric adenocarcinoma (GAC) is the most common histological type of gastric cancer and imposes a considerable health burden globally. The purpose of this study was to identify significant genes and key pathways participated in the initiation and progression of GAC. Four datasets (GSE13911, GSE19826, GSE54129, and GSE79973) including 171 GAC and 77 normal tissues from Gene Expression Omnibus (GEO) database were collected and analyzed. Through integrated bioinformatics analysis, we obtained 69 commonly differentially expressed genes (DEGs) among the four datasets, including 20 upregulated and 49 downregulated genes. The prime module in protein-protein interaction network of DEGs, including ADAMTS2, COL10A1, COL1A1, COL1A2, COL8A1, BGN, and SPP1, was enriched in protein digestion and absorption, ECM-receptor interaction, focal adhesion, PI3K-Akt signaling pathway, and amoebiasis. Furthermore, expression and survival analysis found that all seven hub genes were highly expressed in GAC tissues and 6 of them (except for SPP1) were able to predict poor prognosis of GAC. Finally, we verified the 6 high-expressed hub genes in GAC tissues via immunohistochemistry, Western blot, and RNA quantification analysis. Altogether, we identified six significantly upregulated DEGs as poor prognostic markers in GAC based on integrated bioinformatical methods, which could be potential molecular markers and therapeutic targets for GAC patients.

Sex-based differences in histology, staging, and prognosis among 2983 gastric cancer surgery patients.

BACKGROUNDFew studies have been conducted on sex differences in the incidence, pathophysiology, and prognosis of gastric cancer (GC).AIMTo analyze the differences in GC characteristics according to sex in patients who underwent surgical treatment for GC.METHODSA total of 2983 patients diagnosed with gastric adenocarcinoma who received surgical treatment at the Seoul National University Bundang Hospital between 2003 and 2017 were included. Baseline clinicopathological characteristics, histologic type of GC, overall and GC-specific survival rates, and associated risk factors were analyzed.RESULTSAmong the 2983 patients, 2005 (67.2%) and 978 (32.8%) were males and females, respectively. The average age of the female group (59.36 years) was significantly younger than that of the male group (61.66 years; P < 0.001). Cancer of the gastric body (P < 0.001) and diffuse-type histology (P < 0.001) were more common in females than in males. This trend was more prominent in females younger than 60 years of age, with a significantly higher proportion of diffuse-type cancer than in the male group. Regardless of sex, diffuse-type GC was more common in younger patients, and the proportion of intestinal-type GC increased with age. The overall survival rate was significantly higher in females (P < 0.001). However, this difference disappeared for GC-specific survival (P = 0.168), except for the poor GC-specific survival rate in advanced-stage cancer (stage III or above) in females (P = 0.045). The risk factors for GC-related mortality were older age, upper location of GC, and diffuse- or mixed-type histology. In terms of comorbidities, more males died from diseases other than GC, including other malignancies such as lung cancer, hepatocellular carcinoma, and pancreatic cancer, and respiratory diseases such as interstitial lung disease and chronic obstructive pulmonary disease, while there were relatively more cardiovascular or cerebrovascular deaths in females.CONCLUSIONSex-based differences in GC were observed in clinicopathological features, including age at diagnosis, tumor location, histologic type, survival rate, and comorbidities.

The Value of Gastric Cancer Staging by Endoscopic Ultrasonography Features in the Diagnosis of Gastroenterology.

This research was aimed at exploring the application value of endoscopic ultrasonography (EUS) in the diagnosis of gastric cancer staging and the correlation between staging and clinical features of gastric cancer. A total of 72 patients with gastric cancer were selected and randomly divided into two groups. The patients in the pathological group underwent postoperative pathological examination, while those in the EUS group received preoperative EUS examination. The results showed that the staging accuracy of EUS was 73.33% for T1, 78.57% for T2, 27% for T3, and 100% for T4, compared with the pathological staging. The accuracy of N- and N+ was 42.5% and 82.3% in EUS, respectively, and the total accuracy was 55.7%. There was no considerable difference in the accuracy of T staging between early gastric cancer and advanced gastric cancer (P > 0.05), but there was a considerable difference in N staging (P < 0.05). Lymph node metastasis affected the accuracy of N staging (P < 0.05). The number and location of metastatic lymph nodes did not affect the judgment of metastatic lymph nodes (P > 0.05). In addition, the proportion of understaging and overstaging was greatly different among different lesion sizes and histological types of gastric cancer (P < 0.05). To sum up, the accuracy of EUS for T and N staging of gastric cancer needed to be improved. The location of gastric cancer lesions affected the accuracy of T staging, while the depth of invasion and lymph node metastasis affected the accuracy of N staging.

Gastric epithelial histology and precancerous conditions

The most common histological type of gastric cancer (GC) is gastric adenocarcinoma arising from the gastric epithelium. Less common variants include mesenchymal, lymphoproliferative and neuroendocrine neoplasms. The Lauren scheme classifies GC into intestinal type, diffuse type and mixed type. The WHO classification includes papillary, tubular, mucinous, poorly cohesive and mixed GC. Chronic atrophic gastritis (CAG) and intestinal metaplasia are recommended as common precancerous conditions. No definite precancerous condition of diffuse/poorly/undifferentiated type is recommended. Chronic superficial inflammation and hyperplasia of foveolar cells may be the focus. Presently, the management of early GC and precancerous conditions mainly relies on endoscopy including diagnosis, treatment and surveillance. Management of precancerous conditions promotes the early detection and treatment of early GC, and even prevent the occurrence of GC. In the review, precancerous conditions including CAG, metaplasia, foveolar hyperplasia and gastric hyperplastic polyps derived from the gastric epithelium have been concluded, based on the overview of gastric epithelial histological organization and its renewal.

Increased tensin 4 expression is related to the histological type of gastric cancer.

BACKGROUNDGastric cancer (GC) is one of the most common malignant tumors worldwide. Tensin 4 (TNS4) is an adhesive protein belonging to the tensin family. This protein is located in focal adhesion sites. The TNS4 gene is considered an oncogene in numerous cancers. This protein plays an important role in adhesion, migration and proliferation of cells.AIMTo evaluate expression of TNS4 protein in GC tissues and analysis of the clinical and histopathological parameters as well as the overall survival rate of patients.METHODSThe expression of TNS4 was assessed in 89 patients using immunohistochemistry.RESULTSPositive expression of TNS4 was observed in 49 of 89 patients (55.06%). Higher TNS4 expression was more common in GC tumors with a diameter ≥ 5 cm (P = 0.040). We demonstrated that an increase in TNS4 expression was more frequent in tumors of the histological type without mucinous components than in tumors from mucosal cancers (P = 0.023). Furthermore, TNS4 expression was higher in moderately differentiated tumors than in poorly differentiated and non-differentiated tumors (P = 0.002). Increased TNS4 expression was also noted in the intestinal type of GC according to Lauren’s classification (P = 0.020). No statistically significant correlation was found between the expression of TNS4 and the overall survival rate of patients.CONCLUSIONTNS4 expression was significantly higher in tumors with a diameter ≥ 5 cm of the moderately differentiated intestinal type (according to Lauren’s classification) of GC without a mucinous component. Therefore, increased TNS4 expression is related to the histological type of GC with a better prognosis.

A survival comparison of gastric mucin-producing adenocarcinoma to conventional adenocarcinoma: a SEER database analysis

BackgroundCompared to conventional adenocarcinoma (CA), mucin-producing adenocarcinoma (MPA) is an uncommon histological subtype and is usually separated from other histological types and has been evaluated separately. The objective was to compare the clinicopathological characteristics and survivals of MPA with CA.MethodsWe retrospectively analyzed 1515 MPA patients in SEER database. Log-rank tests and KM survival curves were applied to determine the differences in overall survival (OS) and cancer specific survival (CSS) time.ResultsNo significant differences were noted in OS and CSS time. The MPA patients who were treated with surgery and chemotherapy exhibited longer OS and CSS time periods than those without treatment. MPA patients treated with radiotherapy exhibited similar OS and CSS time with those without radiotherapy. MPA was not a prognostic factor of survival.ConclusionsMPA was a rare histological type of gastric cancer. Patients with MPA exhibited similar prognosis with those with CA. Surgery and chemotherapy were effective treatments for patients with MPA.

The comprehensive genomic profiling and PD-L1 expression of primary lymphoepithelioma-like carcinoma of the stomach.

e16279 Background: Lymphoepithelioma-like carcinoma (LELC) of the stomach is a rare histological type of gastric cancer (GC) with an incidence of 1-4% all GCs, characterized by Epstein-Barr virus infection (EBV+). There is no established agent for patients with LELC of the stomach due to the lack of the genomic data. In this work, we performed the comprehensive genomic profiling and PD-L1 expression of primary LELC of the stomach to investigate the molecular mechanism of tumorigenesis. Methods: Capture-based targeted sequencing was performed on tumor tissue samples collected from 20 patients with LELC of the stomach and 8 patients with LELC of the parotid gland using a panel consisting of 520 cancer-related genes. Tumor tissues were stained by immunohistochemistry for PD-L1 and CD8. PD-L1 expression level was determined by combined positive score (CPS). Tumor mutation burden (TMB) was calculated as a ratio of the total nonsynonymous mutations per total coding region of the panel, excluding copy number variations and fusions. Results: Total of 217 somatic mutations in 127 genes were identified from 18 patients with LELC of the stomach. The most frequently mutated genes included PIK3CA, ARID1A, SMAD4 and KMT2D, occurring in 65% (13/20), 55% (11/20), 30% (6/20), and 25% (5/20) of patients with LELC of the stomach. For LELC of the parotid gland, 13 somatic mutations in 8 genes were identified from 7 patients. All patients with LELC of the stomach/parotid gland were EBV positive and microsatellite-stable. Patients with LELC of the stomach had a significantly higher mutation frequency in PIK3CA (65% vs. 0%, p &lt; 0.01) and ARID1A (55% vs. 0%, p &lt; 0.01) than patients with LELC of the parotid gland. Patients with LELC of the stomach also had a significantly higher mutation frequency in mTOR (70 vs. 0%, p &lt; 0.001) and VEGF signaling pathway (70% vs. 0%, p &lt; 0.001) than patients with LELC of the parotid gland. Compared to LELC of the parotid gland, LELC of the stomach showed a significantly increased TMB (5.0 vs. 1.0 muts/Mb, p &lt; 0.001) and a decreased CPS (47.5 vs. 100.0, p &lt; 0.01). Tumor-infiltrating CD8+ T cell densities in LELC of the stomach and LELC of the parotid gland were comparable. Next, we compared mutational profiling of LELC of the stomach from our cohort to mutational landscape of EBV+ gastric adenocarcinoma obtained from The Cancer Genome Atlas. Patients with LELC of the stomach had a significantly higher mutation frequency in PIK3CA than patients with EBV+ gastric adenocarcinoma (65% vs. 0%, p &lt; 0.001). The mutation frequencies of ARID1A, SMAD4 and KMT2D between patients with LELC of the stomach and EBV+ gastric adenocarcinoma were comparable. Conclusions: This study is the first to elucidate the comprehensive genomic profiling of LELC of the stomach in the Chinese population. Our work demonstrated that genomic landscape of LELC of the stomach is distinctive to LELC of the parotid gland and EBV+ gastric adenocarcinoma.

Eradication therapy for gastric cancer in Inner Mongolia: a single-center study over 10 years

Abstract Objective: To analyze the clinicopathological data of gastric cancer database in The Affiliated Hospital of Inner Mongolia Medical University for the past 10 years, in order to understand the characteristics, diagnosis and treatment of gastric cancer in this area. Methods: The clinical and pathological data of 2049 patients with gastric cancer treated in the Affiliated Hospital of Inner Mongolia Medical University from 2007.1-2017.1 were retrospectively analyzed. All clinical data in the present study were approved by the Ethics Committee of Inner Mongolia Medical University. The efforts were made to keep patient information used in the studies. Results: There were 1619 males (79.01%) and 430 females (20.99%) with an average age of 60.94±10.90. The incidence of gastric antrum was the highest in 830 cases (40.51%) and the proportion of gastric cancer was different in different age groups (c2=58.583, P=0.000). Early stage gastric cancer accounted for 8.83%, while advanced gastric cancer accounted for 91.17%. 922 cases (45.00%) were poorly differentiated adenocarcinoma. There were significant differences in the histological types of gastric cancer among different age groups (c2 = 102.866, P = 0.000). There were 130 cases of Mongolian patients with gastric cancer, and the composition ratio of each age group was similar to that of Han ethnicity. However, incidence location was different from that of the Han ethnicity, 55 cases (42.31%) occurred in esophagogastric junction, followed by gastric antrum. Continuous....