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Molecular Pathology of
Gastric Cancer
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Region Incidence Overall Incidence Males Incidence Females Deaths Overall Deaths Males Deaths Females
USA 21000 12730 8270 10570 6350 4220

Affected Protein Pathway Sub-Type Ethnicity Stage Frequency (%) Gene Amplification Activating Mutation Inactivating Mutation Deletion Promoter Hypermethylation Comment  
APC (adenomatosis polyposis coli) WNT Signaling
intestinal type 60% rare in diffuse type
BCL-2 Apoptosis regulation
12-35% LOH/ overexpression. Negative correlation of expression with depth of invasion, lymph node metastasis and survival
beta-catenin WNT Signaling
intestinal 27%
c-Met (HGFR) Receptor Tyrosine Kinase Signaling
diffuse type 40% Correlation with tumor invasion, lymph node metastasis, poor prognosis
c-Met (HGFR) Receptor Tyrosine Kinase Signaling
intestinal type 20% overexpression
C-Myc Cell Cycle Regulation
40-45% Correlation with poor clinical course/predictor of aggressiveness
CDKN1B (p27, Kip1) Cell Cycle Regulation
40-50% Reduced expression. Correlation with advanced tumor stage/depth of invasion/lymph node metastasis
Cyclin E1 Cell Cycle Regulation
diffuse and intestinal, respectively 10-20% Overexpression. Correlation with disease aggressiveness/lymph node metastasis
E-Cadherin (CDH1) Cell-cell adhesion
Hereditary Diffuse Gastric Carcinoma (HDGC) 50%
E-Cadherin (CDH1) Cell-cell adhesion
sporadic diffuse-type 40 - 83% Correlation of reduced expression with tumor metastatic ability and poor prognosis
EGF diffuse and intestinal, respectively 20 - 40% overexpression
EGFR (ErbB-1 receptor) Receptor Tyrosine Kinase Signaling
difuuse and intestinal, respectively 25 - 50% overexpression
ErbB-2 (Her2/neu) Receptor Tyrosine Kinase Signaling
intestinal advanced gastric carcinoma 10-15% Overexpression. Correlation with advanced tumor stage, lymph node metastasis, liver metastases, poor prognosis
FGFR-2 (k-sam) Receptor Tyrosine Kinase Signaling
diffuse type advanced tumor stage 35% Overexpression. Correlation with advanced tumor stage/poor prognosis
KRAS Ras Signal Transduction Pathway
intestinal 10%
p16INK4a (CDKN2A) Cell Cycle Regulation
intestinal and diffuse, respectively 12-30% Reduced expression. Correlation with tumor invasion/metastasis
p53 p53 Tumor Suppressor Pathway
primary gastric cancer 25 - 40% Correlation of expression with proliferative rate/lymph node metastasis/shortened survival
Pi3-kinase PI3-Kinase Signaling
4 - 25%
PTEN PI3-Kinase Signaling
gastric carcinomas advanced stage 20- 39% loss of expression
RARbeta (retinoid acid receptor, beta) Transcriptional regulation
60-65% Reduced expression
RUNX3 (runt-related transcription factor 3) Transcriptional regulation
45-65% loss of expression
TGF alpha diffuse and intestinal 55-60% overexpression
VEGF diffuse and intestinal, respectively 12- 46% overexpression

See Clinical Trials in in the TTC Database
CANCER.GOV PDQ® - Standard Treatments for Gastric Cancer