14 While some of the genes comprising these expression programmes are expressed exclusively by cancer cells, other cell types within a tumour may also contribute to the gene expression profile. Gene expression profiling represents a powerful technology that can provide an unbiased and holistic ‘molecular snapshot’ of distinct gene expression programmes present within a tumour. Compared with cancer cells, relatively little is known regarding the potential contribution of these other components to GC patient prognosis. However, like all solid tumours, GCs are highly complex entities composed of neoplastic epithelial cells, as well as of vessels, fibroblasts, immune cells and extracellular matrix. So far, prognostic studies in GC have focused primarily on aberrations occurring in the GC cell. 5–9 However, clear prognostic roles have not been consistently observed for most of these factors, particularly when tested in multiple independent patient cohorts. Previous studies attempting to identify additional GC prognostic factors have investigated a variety of clinical, histological (morphological subtypes, grade of differentiation) and molecular factors, including Ki67 expression (a marker of cell proliferation), p53 mutation status, DNA ploidy and human epidermal growth factor receptor 2 (HER2) expression. However, GC patients with the same TNM stage often exhibit distinct clinical outcomes 4 suggesting the existence of additional factors influencing GC disease aggressiveness. Of these, TNM staging is the major tool used by clinicians to predict GC patient prognosis.
#Comprehensive meta analysis plus#
1, 2 Treatment of GC patients is currently based on clinical parameters such as age, performance status and tumour, node, metastasis (TNM) staging, 3 which are collectively used to decide whether a patient should be treated by surgery alone, surgery plus chemotherapy/chemoradiation or chemotherapy alone. Gastric adenocarcinoma (gastric cancer, GC) is a major cause of global cancer mortality. 15Genome Institute of Singapore, Singaporeĭr Patrick Tan, Associate Professor, Cancer and Stem Cell Biology, Duke-NUS Graduate Medical School Singapore, 8 College Road, Singapore, 169857.14Cancer Science Institute of Singapore, Yong Loo Lin School of Medicine, National University of Singapore.13Systems Biology, Division of Cancer Medicine, MD Anderson Cancer Centre, USA.12Department of Medicine (RMH/WH), University of Melbourne, Western Hospital, Footscray, Victoria, Australia.11Cancer Genomics and Biochemistry Laboratory, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia.10Department of Pathology, Singapore General Hospital, Singapore.9Department of Surgery, Yonsei University College of Medicine, South Korea.8Departments of Gastrointestinal Medical Oncology, MD Anderson Cancer Centre, USA.7Department of Internal Medicine, Yonsei Cancer Centre, South Korea.
#Comprehensive meta analysis free#
6Department of Pathology, Free University Medical Center Amsterdam, The Netherlands.5Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore.4Cancer and Stem Cell Biology, Duke-NUS Graduate Medical School, Singapore.3Division of Medical Oncology, National Cancer Centre, Singapore.2Pathology and Tumour Biology, Leeds Institute of Molecular Medicine, University of Leeds, UK.1Cellular and Molecular Research, National Cancer Centre, Singapore.
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