Molecular features of early- vs. late-onset gastric cancer: a systematic review and meta-analysis
摘要
Early-onset gastric cancer (EOGC), diagnosed before age 50, is characterized by distinct clinicopathological features, though its molecular landscape remains poorly defined.
MethodsA systematic literature search of PubMed, Embase, and Web of Science identified studies comparing molecular characteristics of EOGC and late-onset gastric cancer (LOGC). Meta-analyses assessed differences in The Cancer Genome Atlas (TCGA) molecular subtypes, gene mutations, therapeutic biomarkers, and serum tumor markers. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated; heterogeneity was assessed using the I2 statistic.
ResultsEOGC was associated with a higher prevalence of the genomically stable (GS) subtype (OR = 1.71, 95% CI: 1.37–2.12) and a lower prevalence of the chromosomal instability (CIN) subtype (OR = 0.62, 95% CI: 0.50–0.77). CDH1 mutations were more frequent in EOGC (OR = 3.44, 95% CI: 2.85–4.16), while HER2 expression (OR = 0.54, 95% CI: 0.43–0.67), dMMR/MSI-H status (OR = 0.25, 95% CI: 0.12–0.53), and p53 expression (OR = 0.56, 95% CI: 0.39–0.82) were significantly lower. Serum markers including CEA and CA19-9 were also less frequently elevated in EOGC.
ConclusionEOGC represents a biologically distinct subset of gastric cancer with unique genomic and immunological features. These findings support age-specific diagnostic approaches and emphasize the value of multiomic strategies to uncover the mechanisms driving early-onset disease.