ArticleBMC gastroenterology2026
Microsatellite instable early gastric cancers; a distinct molecular profile with HER2 over-expression and increased multiple lesion risk.
Article in BMC gastroenterology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
BACKGROUND/
aimsMicrosatellite instability (MSI) associated gastric cancers (GCs) have a large burden of mutational risk. In advanced gastric cancers (AGCs), the pre-treatment evaluation of MSI and over-expression of HER2 / EGFR could be crucial for prognosis. However, the significance of MSI state, HER2, and EGFR over-expression in early gastric cancer (EGC) are still under investigation.
methodA consecutive study was undertaken from March 2020 to March 2022, and we analyzed 325 gastric cancer tissues (165 EGCs; 160 AGCs) from the patients who had received gastrectomy or endoscopic submucosal dissection.
resultsThe frequencies of MSI and HER2 over-expression were 21.8% (71/ 325), and 14.5% (47/ 325), respectively. The frequency of EGFR over-expression was 48.9% (159/ 325). The infection rate of Helicobacter pylori was 50.8% (165/325), and the infection rate in EGC (58.8%, 97/165) was significantly higher than that in AGC (42.5%, 68/160) (P < 0.01). EGFR overexpression was more frequent in AGC than in EGC (P = 0.03), and there was no statistical difference for MSI and HER2. In MSI positive GCs, HER2 over-expression (P = 0.03) and H. pylori infection (P = 0.03) were more frequent than in microsatellite stable GCs. HER2 over-expression was outstanding in MSI EGCs (P < 0.01), and multiple lesions were observed more clinically.
conclusionThe frequency of H. pylori infection and HER2 over-expression occurred more frequently in MSI positive GCs. In particular, HER2 overexpression was more evident in MSI-EGC. MSI-EGC is a group of diseases with unique molecular biological characteristics and may show rapid tumor growth potential, so special treatment measures may be needed.
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