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Updated: Jan 9, 2026
Author Spotlight: Advancing Early Detection and Treatment of Gastrointestinal Tumors
Published on: February 16, 2024
Macroscopic growth patterns and their molecular implications in gastric carcinoma: toward risk stratification via
Gizem Issin1, Fatih Demir2,3, Diren Vuslat Cagatay2
1Department of Pathology, Erzincan Binali Yildirim University, Mengucek Gazi Training and Research Hospital, Haci Ali akin street, Erzincan, Turkey. gizemissin@gmail.com.
Abstract:
Gastric carcinoma (GC) is a heterogeneous disease with diverse histopathological and molecular features. The Borrmann classification, which reflects the macroscopic growth pattern, has potential value in correlating with molecular characteristics and predicting disease extent and prognosis. However, its relationship with GC molecular subtypes remains incompletely defined. In the present study, we attempted to assess the relationship between Borrmann classification and clinical, pathological, and molecular findings in GC, as well as its impact on overall survival.
Material And Methods:
A retrospective analysis was conducted on 255 patients who underwent surgery for GC between January 2012 and 2021. Cases were classified into types I, II, III, and IV, according to the Borrmann classification. Clinical data, tumor characteristics, molecular marker expression status, and survival data were analyzed in relation to the Borrmann classification.
Result:
The most common macroscopic growth pattern was Borrmann type III (38.8%). Type IV tumors were associated with younger patients, larger size, epithelial-mesenchymal transition-related molecular subtype, diffuse histology, and a higher incidence of peritoneal dissemination. In contrast, type I tumors were more frequently diagnosed at earlier stages and demonstrated well-differentiated morphology, frequent HER2 positivity, and p53 mutant expression. Kaplan-Meier analysis demonstrated clear survival differences among Borrmann types, with type I tumors showing the most favorable outcomes (median 82.2 months) and type IV tumors the poorest (median 34.6 months; log-rank p < 0.001). When adjusted for covariates in the multivariate Cox model, only age, Borrmann type III (compared to type I) and advanced nodal status (pN0 compared to pN2-3) were found to be independent prognostic indicators. Advanced age was consistently associated with reduced survival time, type III tumors resulted in more than a twofold increase in mortality risk, and higher nodal stages were strongly linked to poor outcomes.
Conclusion:
The Borrmann classification showed associations with molecular and pathological features of GC, and survival varied among types, suggesting potential utility for prognostic assessment prior to surgery.
