Molecular profile of gastric adenocarcinoma, relevant epidemiological factors – Systematic review and meta-analysis relating sex with Epstein-Barr virus and unstable microsatellites subtypes

IF 1.4 4区医学 Q4 ONCOLOGY

Asia-Pacific journal of clinical oncology Pub Date : 2023-11-06 DOI:10.1111/ajco.14032

Gabriel Oliveira dos Santos, Warley Abreu Nunes, Waldemir Ferrari Júnior, Luiza Gomes Botega, Adriana Vial Roehe

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引用次数: 0

Abstract

Introduction

Gastric epithelial tumors exhibit morphological heterogeneity, diverse biological behaviors, and different oncopathological pathways. The Cancer Genome Atlas (TCGA) proposed a molecular classification of gastric adenocarcinomas based on genetic and molecular findings, which shows particular characteristics of diagnosis, prognosis, and indirectly, therapeutic alternatives. Within this classification, Epstein-Barr virus-positive (EBV+) and high microsatellite instability (MSI-H) subtypes stand out as subtypes that present a less aggressive biological behavior and a highly mutilated phenotype. This study conducted a systematic review with an emphasis on epidemiological and prognostic factors based on the molecular classification proposed by TCGA.

Methods

A broad, comprehensive, and reproducible search with methodological rigor was conducted for study selection using the ROBINS-I and GRADEpro protocols and appropriate combinations of keywords.

Results

A total of 25 studies were selected: six with a complete classification similar to TCGA and 19 with a distinction between MSI-H and EBV+. The application of meta-analysis calculations reinforces the prevalence of positive Epstein-Barr adenocarcinomas in males and high microsatellite instability in females, with a high level of certainty of evidence and low risk of bias in the analyzed studies due to the rigorous methods used.

Conclusion

The molecular classification proposed by TCGA shows limited dissemination, with MSI-H and EBV+ subtypes being the most researched, probably due to the benefit of the association with immunotherapies. However, the subclassification cannot be restricted to less than a quarter of the cases, and improvements in this aspect are urgent for the construction of knowledge on this important topic of global health.

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胃腺癌的分子特征、相关流行病学因素——与EB病毒和不稳定微卫星亚型的性别相关的系统综述和荟萃分析。

引言：胃上皮肿瘤表现出形态异质性、不同的生物学行为和不同的肿瘤病理途径。癌症基因组图谱（TCGA）根据遗传和分子发现提出了胃腺癌的分子分类，显示了诊断、预后和间接治疗替代方案的特殊特征。在这一分类中，EB病毒阳性（EBV+）和高微卫星不稳定性（MSI-H）亚型是表现出较低攻击性生物学行为和高度残缺表型的亚型。本研究基于TCGA提出的分子分类，对流行病学和预后因素进行了系统综述。方法：使用ROBINS-I和GRADEpro方案以及适当的关键词组合，对研究选择进行了广泛、全面和可重复的方法学严谨搜索。结果：共选择了25项研究：6项具有类似TCGA的完整分类，19项具有MSI-H和EBV+之间的区别。荟萃分析计算的应用加强了男性Epstein-Barr腺癌阳性的患病率和女性微卫星高度不稳定的患病率，由于使用了严格的方法，在分析的研究中证据的确定性很高，偏倚的风险很低。结论：TCGA提出的分子分类显示出有限的传播性，MSI-H和EBV+亚型是研究最多的，这可能是由于与免疫治疗相关的益处。然而，分类不能局限于不到四分之一的病例，这方面的改进对于构建关于全球卫生这一重要主题的知识来说是迫切的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Asia-Pacific journal of clinical oncology 医学-肿瘤学

CiteScore

3.40

自引率

0.00%

发文量

175

审稿时长

6-12 weeks

期刊介绍： Asia–Pacific Journal of Clinical Oncology is a multidisciplinary journal of oncology that aims to be a forum for facilitating collaboration and exchanging information on what is happening in different countries of the Asia–Pacific region in relation to cancer treatment and care. The Journal is ideally positioned to receive publications that deal with diversity in cancer behavior, management and outcome related to ethnic, cultural, economic and other differences between populations. In addition to original articles, the Journal publishes reviews, editorials, letters to the Editor and short communications. Case reports are generally not considered for publication, only exceptional papers in which Editors find extraordinary oncological value may be considered for review. The Journal encourages clinical studies, particularly prospectively designed clinical trials.