期刊
PATHOBIOLOGY
卷 85, 期 1-2, 页码 50-63出版社
KARGER
DOI: 10.1159/000473881
关键词
Gastric cancer; Stomach; Morphological heterogeneity; Molecular heterogeneity; Intratumour heterogeneity
资金
- FCT, the Portuguese Foundation for Science and Technology
- Norte Portugal Regional Programme (NORTE), through the European Regional Development Fund (ERDF) [NORTE-01-0145-FEDER-000003]
- FEDER - Fundo Europeu de Desenvolvimento regional funds through the COMPETE - Operational Programme for Competitiveness and Internationalization (POCI), Portugal
- Portuguese funds through FCT - Foundation for Science and Technology/Ministerio da Ciencia, Tecnologia e Inovacao [POCI-01-0145-FEDER-007274]
- Norte Portugal Regional Programme (NORTE), through the ERDF
- research line - project, Mapping genetic and phenotypic heterogeneity in HER2-positive cancers to anticipate and counteract resistance phenotypes [NORTE-01-0145-FEDER-000029]
- Portuguese Ministry of Science and Technology [MCTES], Contrato Programa no ambito do Programa Investigador FCT [IF/00615/2013]
- POPH - QREN type 4.2, European Social Fund
Gastric cancer (GC) represents a global health concern. Despite advances in prevention, diagnosis, and therapy, GC is still the third leading cause of cancer mortality worldwide, with more than 720,000 estimated deaths in 2012. Overall survival for advanced disease is about 1 year, a dismal prognosis that is partly due to the high levels of biological heterogeneity found in GC. Indeed, GC is a highly heterogeneous disease from morphological and molecular standpoints. The numerous histological and molecular classifications currently available reflect such heterogeneity. Although recent high-throughput studies cluster the molecular data obtained into subgroups with clinical relevance, we still need a practical, prognostic, and predictive classification system, integrating morphological and molecular features, towards the identification of novel therapeutic targets. It is noteworthy that GC heterogeneity encompasses not only interpatient variability (intertumour heterogeneity), but also variations within the same tumour (intratumour heterogeneity). The latter encompasses spatial heterogeneity (in different tumour areas) and temporal heterogeneity (along progression from primary to recurrent and/or metastatic disease). In this review, we analyse the morphological, immunophenotypic, and molecular heterogeneity in GC as the basis for a better understanding of the disease, and discuss the practical implications for diagnostic pathology, prognostic evaluation, and precision therapy. (C) 2017 S. Karger AG, Basel.
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