Gastric cancer is the third most common cause of cancer-related mortality. Genome-wide studies pave way for the delineation of heterogeneities and the possible genomics-guided stratification of tumors. Numerous whole-genome profiles have been established from different parts of globe and are largely lacking from South India. We performed genome-wide expression profiling of 50 gastric tumors and 15 adjacent normal tissues from Madurai, India. The genes differentially expressed in gastric tumors were found comparable with genes from other cohorts across globe. Integrative genomic analysis revealed the transcription factors LEF1, SP1, NFAT, AP1, PAX4, E2F and ATF2 to be upregulated and p53, HNF3, ESR, BMP2, PRC2/SUZ12/EED and NRF2 to be downregulated in gastric tumors. Pathway enrichment analysis showed the higher enrichment of focal adhesion, TGF-β, VEGF, EGFR, MAPK and EMT among the genes upregulated. The gastric acid secretion, digestion and absorption of minerals were identified to be diminished in gastric tumors. In a gene set based comparison of molecular subtypes, the frequency was found to differ between TCGA and Madurai cohorts indicating the disparity in molecular genomic patterns across populations. Thus the identification of the transcription factors, signaling pathways and molecular processes dysregulated in gastric tumors is resourceful and reveals the potential therapeutic targets for the eventual development of targeted gastric cancer therapeutics.
Conclusion: EC including wedge resection of GB bed should be recommended for T2 incidental GBC. Because systemic recurrence was more common and recurrence occurred more frequently in patients with LN metastasis, postoperative adjuvant therapy should be considered especially for the patients with lymph node metastasis.
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