Molecular profiling of gastric cancer: toward personalized cancer medicine.

摘要

Gastric cancer is the fourth most common cancer worldwide and the second leading cause of global cancer deaths. The prognosis of patients diagnosed with gastric cancer continues to be dismal, despite improving surgical and adjuvant treatment approaches, with a 5-year overall survival less than 25%. The high disease incidence and poor outcomes continue to make gastric cancer a topic of active clinical and basic scientific research. Notwithstanding these efforts, relatively little is known about the molecular changes that contribute to the development of this deadly disease and how they may influence outcomes and therapeutic results. Gastric cancer can be considered a multifactorial disease because many inherited and environmental factors play a role in its carcinogenesis, including the genetic background of the host, infectious agents such as Helicobacter pylori, and dietary habits. Gastric cancer is a heterogeneous disorder that can be divided into at least the following two main histologic types on the basis of the Lauren classification: intestinal and diffuse types. These two types have distinct morphologic, clinical, and epidemiologic features and may also represent a different molecular mechanism of tumor development and progression.