Virchows Archiv

, Volume 473, Issue 6, pp 687–695 | Cite as

Immunohistochemical classification of gastric cancer based on new molecular biomarkers: a potential predictor of survival

  • Cristina Díaz del ArcoEmail author
  • Lourdes Estrada Muñoz
  • Elena Molina Roldán
  • Mª Ángeles Cerón Nieto
  • Luis Ortega Medina
  • Soledad García Gómez de las Heras
  • Mª Jesús Fernández Aceñero
Original Article


Several classification systems have been described for stratifying patients with gastric carcinoma (GC). However, their prognostic value is low, and there is an urgent need for identification of molecular markers and development of new classifications. Retrospective study of 206 cases of GC diagnosed and surgically resected in our hospital between 2000 and 2017. Clinicopathological features of all cases were assessed and tissue microarrays were constructed for immunohistochemical (IHC) study. Patients were stratified based on IHC results. Mean patient age was 71 years and most patients were male (54.6%). Most tumors were located in the gastric antrum and body, and they were mostly fungoid or ulcerative lesions. GC were mainly intestinal-type tumors and 60.3% were diagnosed at pT3. 56.2% of patients showed recurrences and 29.4% died due to GC. According to our IHC classification, 23.5% of tumors showed microsatellite instability, 6% were E-cadherin negative, 53.5% were stable-p53 not overexpressed, and 17% were stable with p53 overexpression. IHC classification was significantly correlated with patient gender, gross morphology, Laurén classification, tumor necrosis, perineural infiltration, type of leading edge, and patient outcome. Multivariate analysis showed that IHC subtype was significantly and independently associated with overall survival, together with clinical symptoms, signet cell phenotype, tumor grade and vessel invasion. The application of IHC classifications based on molecular biomarkers in clinical practice can aid in the stratification of GC patients. More studies are needed to evaluate the reproducibility and clinical significance of these classifications.


Molecular Gastric Classification Immunohistochemistry Prognosis 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Research involving human participants and/or animals

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Retrospective study

For this type of study formal consent is not required. This study has been reviewed and approved by the Ethics Committee at Hospital Clínico San Carlos.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Cristina Díaz del Arco
    • 1
    • 2
    Email author
  • Lourdes Estrada Muñoz
    • 3
    • 4
  • Elena Molina Roldán
    • 1
  • Mª Ángeles Cerón Nieto
    • 1
  • Luis Ortega Medina
    • 1
    • 2
  • Soledad García Gómez de las Heras
    • 4
  • Mª Jesús Fernández Aceñero
    • 1
    • 2
  1. 1.Department of Surgical PathologyHospital Clínico San CarlosMadridSpain
  2. 2.Complutense University of MadridMadridSpain
  3. 3.Department of Surgical PathologyHospital Rey Juan CarlosMadridSpain
  4. 4.Rey Juan Carlos University, AlcorcónMadridSpain

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