Molecular diagnosis of gastric cancer: present and future |
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Authors: | Wataru Yasui Naohide Oue Hiroki Kuniyasu Reiko Ito Eiichi Tahara Hiroshi Yokozaki |
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Institution: | (1) First Department of Pathology, Hiroshima University School of Medicine, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan, JP;(2) Department of Oncological Pathology, Cancer Center, Nara Medical University, Nara, Japan, JP;(3) Hiroshima Cancer Seminar Foundation, Hiroshima, Japan, JP |
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Abstract: | Although histopathological diagnosis is extremely useful for the definitive as well as the supportive diagnosis of gastric
cancer in clinical practice, it is limited in certain respects. Over the past 15 years, integrated research in molecular pathology
has clarified the details of genetic and epigenetic abnormalities of cancer-related genes in the course of the development
and progression of gastric cancer. These abnormalities, which include telomerase activation, genetic instability, and abnormalities
in oncogenes, tumor suppressor genes, cell-cycle regulators, cell adhesion molecules, and DNA repair genes, could be effective
markers in the molecular diagnosis of gastric cancer. It is possible that the molecular analysis of these alterations in histopathology
specimens may overcome deficiencies in diagnoses that depend only on histomorphology, and, consequently, we may be able to
improve the differential diagnosis of cancer, obtain information on the grade of malignancy, and identify patients at high
risk of developing multiple primary cancers. In Hiroshima, we have established a system of molecular-pathological diagnosis
as a routine service; about 5000 lesions of the stomach have been subjected to this diagnosis, and much useful information
has been obtained. In the near future, genetic analysis by means of DNA microarray may become routine in the diagnosis of
gastric cancer. Genetic analysis of histopathology specimens may make clear the characteristics of individual cancers; indicating
the common and specific features of molecular pathogenesis that may be directly connected with gene therapy or molecular-targeted
therapy. By analyzing the relationship between single-nucleotide polymorphisms and cancer susceptibility, we will be able
to obtain information on cancer prevention from histopathology samples.
Received: May 21, 2001 / Accepted: July 3, 2001 |
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Keywords: | Molecular diagnosis Gastric cancer Histopathology Genetic alterations Epigenetic alterations |
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