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Updated: Jul 6, 2025

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Implementing an On-Slide Molecular Classification of Gastric Cancer: A Tissue Microarray Study.

Simona Costache1,2, Rebecca de Havilland2, Sofia Diaz McLynn2

  • 1Pathology Department, University of Medicine and Pharmacy "Carol Davila", 020021 Bucharest, Romania.

Cancers
|January 11, 2024
PubMed
Summary

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A new molecular classification for gastric cancer (GC) using on-slide biomarkers is feasible and identifies six subgroups for personalized treatment. This approach, utilizing formalin-fixed and paraffin-embedded tissue, aids in selecting appropriate therapies for GC patients.

Area of Science:

  • Oncology
  • Molecular Pathology
  • Cancer Biomarkers

Background:

  • Gastric cancer (GC) is a leading cause of cancer death globally.
  • Personalized treatment strategies are crucial for improving GC outcomes.
  • A molecular classification using accessible on-slide biomarkers on formalin-fixed and paraffin-embedded (FFPE) tissue is needed for guiding therapy.

Purpose of the Study:

  • To assess the implementation and feasibility of a modified, inclusive working classification for gastric cancer.
  • To categorize GC into six molecular subgroups using on-slide biomarkers.
  • To evaluate the utility of biomarkers for targeted therapies within this classification.

Main Methods:

  • Construction of a tissue microarray library from 79 FFPE GC resection cases.
Keywords:
Claudin18.2E-cadherinEBERHer2MMRPD-L1beta-cateningastric cancermolecular classificationp53

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  • Application of a restricted panel of on-slide markers (EBER, MMR, E-cadherin, beta-catenin, p53).
  • Definition of interpretation algorithms and assignment of cases to molecular subtypes.

    • Main Results:

    • The classification assigned a diagnostic subgroup to 92% of cases.
    • Molecular subgroup distribution: GC EBV(+) (6%), GC dMMR (20%), GC EMT (14%), GC CIN (23%), GC GS (29%), GC NOS (8%).
    • The observed proportions align with findings from other published series.

    Conclusions:

    • The proposed working classification is practical, utilizing widely available and easily interpretable histopathology markers.
    • Widespread implementation of this classification for gastric cancer appears feasible.
    • Further studies using endoscopic biopsies are recommended to validate this classification.