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2018 ; 472
(3
): 369-382
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Gastric cancer: immunohistochemical classification of molecular subtypes and
their association with clinicopathological characteristics
#MMPMID29046940
Birkman EM
; Mansuri N
; Kurki S
; Ålgars A
; Lintunen M
; Ristamäki R
; Sundström J
; Carpén O
Virchows Arch
2018[Mar]; 472
(3
): 369-382
PMID29046940
show ga
Gastric cancer is traditionally divided into intestinal and diffuse histological
subtypes, but recent molecular analyses have led to novel classification
proposals based on genomic alterations. While the intestinal- and diffuse-type
tumours are distinguishable from each other at the molecular level,
intestinal-type tumours have more diverse molecular profile. The technology
required for comprehensive molecular analysis is expensive and not applicable for
routine clinical diagnostics. In this study, we have used immunohistochemistry
and in situ hybridisation in molecular classification of gastric adenocarcinomas
with an emphasis on the intestinal subtype. A tissue microarray consisting of 244
gastric adenocarcinomas was constructed, and the tumours were divided into four
subgroups based on the presence of Epstein-Barr virus, TP53 aberrations and
microsatellite instability. The intestinal- and diffuse-type tumours were
separately examined. The distribution of EGFR and HER2 gene amplifications was
studied in the intestinal-type tumours. Epstein-Barr virus positive
intestinal-type tumours were more common in male patients (p = 0.035) and most
often found in the gastric corpus (p = 0.011). The majority of the
intestinal-type tumours with TP53 aberrations were proximally located
(p = 0.010). All tumours with microsatellite instability showed intestinal-type
histology (p = 0.017) and were associated with increased overall survival both in
the univariate (p = 0.040) and multivariate analysis (p = 0.015). In conclusion,
this study shows that gastric adenocarcinomas can be classified into biologically
and clinically different subgroups by using a simple method also applicable for
clinical diagnostics.