Cancer Science Institute of Singapore, National University of Singapore, Singapore.
Cancer and Stem Cell Biology Program, Duke-NUS Medical School, Singapore.
Cancer Sci. 2019 Nov;110(11):3405-3414. doi: 10.1111/cas.14191. Epub 2019 Sep 25.
Gastric cancer (GC) remains the fifth most prevalent cancer worldwide and the third leading cause of global cancer mortality. Comprehensive -omic studies have unveiled a heterogeneous GC landscape, with considerable molecular diversity both between and within tumors. Given the complex nature of GC, a long-sought goal includes effective identification of distinct patient subsets with prognostic and/or predictive outcomes to enable tailoring of specific treatments ("precision oncology"). In this review, we highlight various approaches to molecular classification in GC, covering recent genomic, transcriptomic, proteomic and epigenomic features. We pay special attention to the translational significance of classifier systems and examine potential confounding factors which deserve further investigation. In particular, we discuss recent advancements in our knowledge of intra-subtype, intra-patient and intra-tumor heterogeneity, and the pivotal role of the tumor stromal microenvironment.
胃癌（GC）仍然是全球第五大常见癌症，也是全球癌症死亡的第三大主要原因。全面的组学研究揭示了 GC 具有异质性的景观，肿瘤之间和内部存在相当大的分子多样性。鉴于 GC 的复杂性，一个长期追求的目标包括有效识别具有预后和/或预测结果的不同患者亚组，以实现特定治疗方法的定制（“精准肿瘤学”）。在这篇综述中，我们重点介绍了 GC 中分子分类的各种方法，涵盖了最近的基因组、转录组、蛋白质组和表观基因组特征。我们特别关注分类器系统的转化意义，并检查值得进一步研究的潜在混杂因素。特别是，我们讨论了我们对亚型内、患者内和肿瘤内异质性以及肿瘤基质微环境的关键作用的最新认识。
