Geographic variation in molecular subtype for gastric adenocarcinoma

The presence of distinct molecular subgroups of gastric cancer (GC) has been recently highlighted in Gut.1 2 However, there has been little focus on the geographic distribution of molecular subgroups. Differences in GC molecular subtypes were assessed using data from The Cancer Genome Atlas (TCGA). Razvan et al established four clinically relevant molecular subtypes, which are MSS (microsatellite stable)/TP53–, MSS/TP53+, MSI (microsatellite instability) and MSS/EMT (epithelial–mesenchymal transition), further delineating GC.3 The clinical significance has been evaluated in a recent study using the TCGA proposed comprehensive molecular classification of patients with GC into four subtypes: Epstein-Barr virus (EBV), chromosomal instability (CIN), MSI and genomically stable (GS). Sohn et al reported that CIN and MSI subtypes had better overall survival than GS, but worse than EBV subtypes.4 Identification of molecular subtypes of GC may offer improved ways to monitor the progression, and predict prognosis5 and distinct therapeutic features.

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