Paves the way for standard cancer treatment at the edge of the stomach and esophagus

Cancer that occurs at the border between the two organs of the digestive tract from the esophagus to the stomach is called “gastric-esophageal adenocarcinoma.” Although gastric cancer is rarely seen in Korea, where gastric cancer is common, it has recently increased rapidly around the world and the number of cases in Korea is increasing.

The location of adenocarcinoma at the gastroesophageal border is somewhat ambiguous between the stomach and the esophagus, and the controversy over whether it should be considered gastric cancer or a type of esophageal cancer is divided. To clarify this, the characteristics of the two cancers and adenocarcinomas of the gastroesophageal border must be compared in detail, but since each region occurs primarily, there is a problem that is difficult to study in a single country or institution. Therefore, biological history, classification, standard treatment, staging, etc. are not clearly established, so treatment development is slow and surgical treatment is known to be more difficult and more difficult than surgery. gastric cancer overview.

Consequently, Professor Seo Yoon-seok’s research team of Surgery at Seoul National University Bundang Hospital announced on the 28th that through a joint study with the Jackson Laboratory and the MD Anderson Cancer Center in the United States Together, they revealed the characteristics of cancer that occurs at the border of the stomach and esophagus and suggested a new method of molecular biological classification. For this study, we analyzed TCGA (the Cancer Genome Atlas), the world’s largest genome database, and next-generation genome data from Seoul National University Hospital, systematically combining and spanning the two, stomach cancer, esophageal cancer, and stomach cancer that mainly occur in different regions. Adenocarcinoma of the esophageal border was compared and analyzed.

As a result, it was found that the adenocarcinoma of the gastroesophageal border can be classified into ‘cancer of the gastric gastroesophageal border’, which has the characteristics of gastric cancer, and ‘cancer of the gastroesophageal border of the esophagus’, which is similar to cancer of the esophagus. The proportion of gastroesophageal cancers of the gastroesophageal and esophageal regions in the set was approximately 2 to 1, and the two had clearly different characteristics in terms of biological signals, RNA expression, and DNA copy number variation.

Of note, the response of the drug to the target therapy was different when cell line tests were performed for the two types of cancers identified above. Based on this, it is expected that the research and development of an optimized treatment strategy for each person will advance the development of treatment for gastroesophageal adenocarcinoma, which has a poor prognosis. In particular, these results are expected to contribute greatly to the preparation of international standard treatments, as they were confirmed by both the genome data from Seoul National University Hospital and TCGA.

Professor Seo Yoon-seok said: “This study is significant because it solved the age-old medical problem of whether gastroesophageal cancer is gastric or esophageal cancer using a molecular biology approach.” Additionally, by increasing understanding of adjacent upper gastric cancer and esophageal cancer, it is hoped that we can provide a higher level of personalized gastrointestinal cancer treatment strategy. ”The study was published in the world’s oldest and most prestigious journal, ‘Annals of Surgery’.

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