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      One stomach, two subtypes of carcinoma—the differences between distal and proximal gastric cancer

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          Abstract

          Gastric cancer (GC) is one of the most common malignant tumors of the digestive tract, posing a significant risk to human health. Over the past 10 years, the pathological characteristics and the prognosis of GC have been determined based on the locations of the tumors that were then classified into two types—proximal and distal GC. This review focuses on the differences in epidemiology, etiology, cell source, pathological characteristics, gene expression, molecular markers, manifestations, treatment, prognosis, and prevention between proximal and distal GC to provide guidance and a basis for clinical diagnosis and treatment.

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          Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries

          Hyuna Sung, Jacques Ferlay, Rebecca Siegel … (2021)
          This article provides an update on the global cancer burden using the GLOBOCAN 2020 estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer. Worldwide, an estimated 19.3 million new cancer cases (18.1 million excluding nonmelanoma skin cancer) and almost 10.0 million cancer deaths (9.9 million excluding nonmelanoma skin cancer) occurred in 2020. Female breast cancer has surpassed lung cancer as the most commonly diagnosed cancer, with an estimated 2.3 million new cases (11.7%), followed by lung (11.4%), colorectal (10.0 %), prostate (7.3%), and stomach (5.6%) cancers. Lung cancer remained the leading cause of cancer death, with an estimated 1.8 million deaths (18%), followed by colorectal (9.4%), liver (8.3%), stomach (7.7%), and female breast (6.9%) cancers. Overall incidence was from 2-fold to 3-fold higher in transitioned versus transitioning countries for both sexes, whereas mortality varied <2-fold for men and little for women. Death rates for female breast and cervical cancers, however, were considerably higher in transitioning versus transitioned countries (15.0 vs 12.8 per 100,000 and 12.4 vs 5.2 per 100,000, respectively). The global cancer burden is expected to be 28.4 million cases in 2040, a 47% rise from 2020, with a larger increase in transitioning (64% to 95%) versus transitioned (32% to 56%) countries due to demographic changes, although this may be further exacerbated by increasing risk factors associated with globalization and a growing economy. Efforts to build a sustainable infrastructure for the dissemination of cancer prevention measures and provision of cancer care in transitioning countries is critical for global cancer control.
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            Comprehensive molecular characterization of gastric adenocarcinoma

            Adam J. Bass, Vesteinn Thorsson, Ilya Shmulevich … (2015)
            Gastric cancer is a leading cause of cancer deaths, but analysis of its molecular and clinical characteristics has been complicated by histological and aetiological heterogeneity. Here we describe a comprehensive molecular evaluation of 295 primary gastric adenocarcinomas as part of The Cancer Genome Atlas (TCGA) project. We propose a molecular classification dividing gastric cancer into four subtypes: tumours positive for Epstein–Barr virus, which display recurrent PIK3CA mutations, extreme DNA hypermethylation, and amplification of JAK2, CD274 (also known as PD-L1) and PDCD1LG2 (also knownasPD-L2); microsatellite unstable tumours, which show elevated mutation rates, including mutations of genes encoding targetable oncogenic signalling proteins; genomically stable tumours, which are enriched for the diffuse histological variant and mutations of RHOA or fusions involving RHO-family GTPase-activating proteins; and tumours with chromosomal instability, which show marked aneuploidy and focal amplification of receptor tyrosine kinases. Identification of these subtypes provides a roadmap for patient stratification and trials of targeted therapies.
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              Epidemiology of gastric cancer.

              Katherine D Crew, Alfred I Neugut (2006)
              The incidence and mortality of gastric cancer have fallen dramatically in US and elsewhere over the past several decades. Nonetheless, gastric cancer remains a major public health issue as the fourth most common cancer and the second leading cause of cancer death worldwide. Demographic trends differ by tumor location and histology. While there has been a marked decline in distal, intestinal type gastric cancers, the incidence of proximal, diffuse type adenocarcinomas of the gastric cardia has been increasing, particularly in the Western countries. Incidence by tumor sub-site also varies widely based on geographic location, race, and socio-economic status. Distal gastric cancer predominates in developing countries, among blacks, and in lower socio-economic groups, whereas proximal tumors are more common in developed countries, among whites, and in higher socio-economic classes. Diverging trends in the incidence of gastric cancer by tumor location suggest that they may represent two diseases with different etiologies. The main risk factors for distal gastric cancer include Helicobacter pylori (H pylori) infection and dietary factors, whereas gastroesophageal reflux disease and obesity play important roles in the development of proximal stomach cancer. The purpose of this review is to examine the epidemiology and risk factors of gastric cancer, and to discuss strategies for primary prevention.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Gastroenterol Rep (Oxf)
                Journal ID (iso-abbrev): Gastroenterol Rep (Oxf)
                Journal ID (publisher-id): gastro
                Title: Gastroenterology Report
                Publisher: Oxford University Press
                ISSN (Electronic): 2052-0034
                Publication date Collection: December 2021
                Publication date (Electronic): 15 November 2021
                Publication date PMC-release: 15 November 2021
                Volume: 9
                Issue: 6
                Pages: 489-504
                Affiliations
                Department of Gastrointestinal Surgery, Shanghai General Hospital, Shanghai Jiao Tong University , Shanghai, P. R. China
                Author notes
                Corresponding author. Department of Gastrointestinal Surgery, Shanghai General Hospital, Shanghai Jiao Tong University, No.100 Haining Road, Hongkou District, Shanghai 200080, P. R. China. Tel: +86-13381758371; Email: richard-hc@ 123456sohu.com

                Yuan Zhang and Peng-Shan Zhang contributed equally to this paper.

                Author information
                https://orcid.org/0000-0001-9284-9404
                Article
                Publisher ID: goab050
                DOI: 10.1093/gastro/goab050
                PMC ID: 8677565
                PubMed ID: 34925847
                SO-VID: ef339ada-050f-478e-bc81-9f9eb02204fe
                Copyright © © The Author(s) 2021. Published by Oxford University Press and Sixth Affiliated Hospital of Sun Yat-sen University
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License ( https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

                History
                Date received : 09 February 2021
                Date revision received : 13 July 2021
                Date accepted : 13 August 2021
                Page count
                Pages: 16
                Funding
                Funded by: National Natural Science Foundation of China, DOI 10.13039/501100001809;
                Award ID: 81772526
                Award ID: 82072662
                Funded by: Shanghai Municipal Education Commission-Gaofeng Clinical Medicine Grant Support ;
                Award ID: 20161425
                Funded by: Shanghai Jiao Tong University Medical Cross Fund;
                Award ID: YG2017MS28
                Funded by: Science and Technology Commission Project of Songjiang District;
                Award ID: 18SJKJGG23
                Award ID: 19SJKJGG22
                Funded by: Three-year Action Plan for Clinical Skills and Clinical Innovation in Shanghai-level Hospitals;
                Award ID: SHDC2020CR4022
                Funded by: 2021 Shanghai “Rising Stars of Medical Talent” Youth Development Program: Outstanding Youth Medical Talents;
                Categories
                Subject: Review Articles
                Subject: AcademicSubjects/MED00260

                Keywords: gastric cancer,epidemiology,pathology,therapeutics,prognosis
                Data availability:
                Keywords: gastric cancer, epidemiology, pathology, therapeutics, prognosis

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