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Review
. 2020 Oct 5:5:52.
doi: 10.21037/tgh.2020.01.02. eCollection 2020.

Diffuse gastric cancer: histologic, molecular, and genetic basis of disease

Pritish Iyer  1 , Maitham Moslim  2 , Jeffrey M Farma  2 , Crystal S Denlinger  1
Affiliations
Review

Diffuse gastric cancer: histologic, molecular, and genetic basis of disease

Pritish Iyer et al. Transl Gastroenterol Hepatol. .

Abstract

Diffuse gastric cancer (DGC) is a distinct histopathologic and molecular disease, characterized by mutations in CDH1, RHOA, and others. In addition, DGC is associated with familial syndromes, including hereditary DGC and germline mutation in CDH1. Clinically, this subtype of gastric adenocarcinoma is associated with a poor prognosis and possible resistance to available systemic therapies. An understanding of the genetic and molecular underpinnings of DGC may help inform of its clinical behavior and aid in screening, diagnosis, and response to treatment. In this review, we will review the current histologic, molecular, and genetic landscape of DGC and its relevance to clinical practice.

Keywords: Diffuse; cancer; gastric.

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Conflict of interest statement

Conflicts of Interest: Dr. Crystal Denlinger has received advisory board honoraria from Astellas, Exelixis, Bayer, Merck, Bristol Myer Squibb, Eli Lilly & Co, EMD Serono, and BeiGene. Dr. Denlinger has received institutional grant support from Array BioPharma, Amgen, Advaxis, Bristol Myer Squibb, Astra Zeneca, Sanofi, BeiGene, Merrimack Pharmaceuticals, Roche/Genentech, Macrogenics, Lycera, Zymeworks, and Agios Pharmaceuticals. Dr. Jeffrey Farma is on the data safety monitoring board for Delcath. The other authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Intestinal type gastric adenocarcinoma. (A) Malignant glands of this intestinal (tubular) adenocarcinoma infiltrate the gastric wall, with benign oxyntic type mucosa at the top of the image. (B) The malignant glands are composed of dilated and slit-like branching tubules. Hematoxylin and eosin stained sections, original magnification, A: 4×, B: 10×.
Figure 2
Figure 2
Diffuse type gastric adenocarcinoma. (A) At low power the malignant cells have a diffuse pattern of involvement, and may be difficult to detect. (B) At higher power, the tumor is easier to recognize as a poorly cohesive, signet-ring cell carcinoma, and is infiltrating through the muscularis propria into subserosal adipose tissue. Hematoxylin and eosin stained sections, original magnification, A: 4×, B: 10×.
See this image and copyright information in PMC

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