Molecular-Like Classification in Gastric Adenocarcinomas: Correlation with Clinicopathological Features and Prognosis
International Journal of Surgical Pathology, cilt.34, sa.4, ss.858-865, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 34 Sayı: 4
- Basım Tarihi: 2026
- Doi Numarası: 10.1177/10668969251397612
- Dergi Adı: International Journal of Surgical Pathology
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE, Academic Search Ultimate (EBSCO), Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest)
- Sayfa Sayıları: ss.858-865
- Anahtar Kelimeler: gastric adenocarcinomas, molecular classification, immunohistochemistry, chromosomal in situ hybridization, prognosis
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Aim: Molecular classifications in gastric cancer are expensive and require experience. This study aimed to establish a molecular-like classification and to investigate the correlation of the classification with clinicopathological features and its prognostic significance. Materials-Methods: In 202 gastric cancer patients who underwent surgery between 2011 and 2019, the clinicopathological features of the tumors were re-evaluated, and the tumors were grouped by molecular-like classification using immunohistochemistry (MLH1, PMS2, MSH2, MSH6, p53, E-cadherin) and chromosomal in situ hybridization (EBER): EBV positive tumors (EBV+), tumors with microsatellite instability (MSI), genomically stable tumors (GS), chromosomal unstable tumors (CUN) and unclassifiable gastric tumors (G-NOS). Results: Twelve of the patients were in the EBV+, 22 in the MSI, 27 in the GS, 76 in the CUN and 65 in the G-NOS group. EBV + tumors were associated with high-grade tubular/papillary morphology and GS tumors were associated with poorly cohesive/mixed type, while tumors in the MSI group were associated with low-grade tubular/papillary morphology (p < .0001). Marked tumor budding was the least in MSI tumors and the most in GS tumors (p = .018). The longest survival time was in the patients of EBV + group, while the shortest survival time was in the patients of GS group (p = .029). Cox regression analysis indicated that age, lymphovascular invasion, positive surgical margins, low-grade tubular and papillary histological types, two groups within molecular- like classification (MSI and GS) were independent prognostic factors (p < .05). Conclusion: Molecular-like classification holds promise as a low-cost, easy-to-implement classification that can be used predictively in prognosis. However, molecular-based studies with large series are still needed to determine whether it is a pretest or alternative of molecular classifications.