ArticleJournal of gastroenterology2019
Molecular subtype switching in early-stage gastric cancers with multiple occurrences.
Article in Journal of gastroenterology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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Who cites it
22 citing papers in PubMed, 23 citations in OpenAlex.
- Somatic alterations and mutational burden are potential predictive factors for metachronous development of early gastric cancer.Scientific reports · 2020Trial
- Paired tumor-normal targeted sequencing supports clonal independence of multiple primary malignancies in patients with gastrointestinal stromal tumors.International journal of clinical oncology · 2026Article
- Immunotherapy-based neoadjuvant treatment of gastric cancer with elevated serum AFP: a case report.Journal of medical case reports · 2026Article
- Analysis of perioperative chemotherapy-mediated genomic changes in gastric cancer.BMC gastroenterology · 2025Article
- Decoding Genomic Diversity to Guide Tumor Lesion-Specific Treatment of Multifocal Hepatocellular Carcinoma.Cancer medicine · 2025Article
- A novel algorithm for the detection of microsatellite instability in endometrial cancer using next‑generation sequencing data.Oncology letters · 2025Article
- Case Report: A case of synchronous multiple early gastric cancer with a microsatellite instability-high phenotype.Frontiers in oncology · 2025Article
- The correlation between the main and minor lesions of synchronous multiple gastric neoplasms assessed gastroscopically and microscopically.Surgical endoscopy · 2024Article
- Individualized Endoscopic Surveillance for Metachronous Gastric Cancer After Endoscopic Submucosal Dissection: A Retrospective Observational Study.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2023Observational
- Validity of pathological diagnosis for early colorectal cancer in genetic background.Cancer medicine · 2023Article
- Elucidation of genomic origin of synchronous endometrial and ovarian cancer (SEO) by genomic and microsatellite analysis.Journal of gynecologic oncology · 2023Review
- Simple IHC reveals complex MMR alternations than PCR assays: Validation by LCM and next-generation sequencing.Cancer medicine · 2022Article
- Diagnosis and clinical implication of collision gastric adenocarcinomas: a case report.Surgical case reports · 2022Article
- Exploring microsatellite instability in patients with advanced hepatocellular carcinoma and its tumor microenvironment.JGH open : an open access journal of gastroenterology and hepatology · 2021Article
- Multi-regional sequencing reveals clonal and polyclonal seeding from primary tumor to metastases in advanced gastric cancer.Journal of gastroenterology · 2020Article
- Dual-molecular barcode sequencing detects rare variants in tumor and cell free DNA in plasma.Scientific reports · 2020Article
- Genomic Characterization of Non-Invasive Differentiated-Type Gastric Cancer in the Japanese Population.Cancers · 2020Article
- Genomic Profiling IdentifiedFrontiers in oncology · 2020Article
- Sintilimab, a PD-1 Inhibitor, Completely Reversed Rarely Refractory Hypofibrinogenemia in a Gastric Cancer Patient: A Case Report and Review of the Literature.Frontiers in oncology · 2020Article
- Accurate detection of KRAS, NRAS and BRAF mutations in metastatic colorectal cancers by bridged nucleic acid-clamp real-time PCR.BMC medical genomics · 2019Article
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Authors and funding
13 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundMultiple gastric cancers at the same time (synchronous) or recurrence after 1 year (metachronous) are frequently encountered. Since their genetic profiles were not well elucidated, we molecularly subtyped the genetic events of synchronous and metachronous early-stage gastric cancers.
methodsWe studied mismatch repair (MMR) genes in 84 tumors from 31 patients (15 synchronous and 16 metachronous) by immunohistochemistry. We performed microsatellite instability analysis and targeted sequencing of 58 significantly mutated genes (SMGs) in 35 tumors from thirteen patients. Genomic data from TCGA were used for comparisons with advanced-stage cancers.
resultsAmong the 31 patients, at least one deficient-MMR (dMMR) tumor was observed in eight (26%). Of eight patients, seven showed a mixture of proficient-MMR (pMMR) and dMMR tumors. The one case with only dMMR had six recurrent tumors within 2 years. To further subtype, we sequenced 58 SMGs in 35 samples (25 pMMR and 10 dMMR) from thirteen patients. In 35 samples, 163 mutations were identified, but none matched in almost cases, strongly indicating different clonal origins, whether synchronous or metachronous occurrences. Of the 25 pMMR cases, 1 belonged to Epstein-Barr virus (EBV), 24 belonged to chromosomal instability (CIN) subtypes. Of the thirteen cases, repetitive CIN, a mixture of CIN and MSI, a mixture of CIN and EBV, and repetitive MSI were observed in nine (70%), two (15%), one (8%) and one (8%), respectively.
conclusionsDespite multiple tumors occurring in the same patient simultaneously or several years apart, clonal origin was totally different. 'Switching' or 'mixing' of dMMR and pMMR, EBV or CIN occurred, which had clinical relevance with regard to immunotherapy.
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