Mixed-type gastric carcinoma: classification, morphological diagnosis and prognosis of the disease

Abstract

Gastric cancer is one of the most common malignant neoplasms in humans. Helicobacter pylori (H. pylori) infection, high salt intake, low consumption of fresh fruits and vegetables, and smoking are a few best-known risk factors for gastric cancer. Back in 1965, Lauren P.A. proposed to clasify gastric carcinomas in three histological types: intestinal, diffuse, and mixed. This classification is still relevant nowadays, allowing to predict the surgical intervention extent, chemotherapy regimen and the course of the disease. This paper reviews mixed-type gastric carcinomas, which, in comparison with other types, is characterized by senior age (over 65 years) of the patients, a larger tumor size, pronounced local tumor invasion, and a high frequency of metastasis found both in the lymph nodes and in other organs, which determines the relevance of this topic. The search of literature was performed using Scopus and Web of Science databases in PubMed platform, Elibrary was used for the search among articles in Russian. Further in-depth studies of the mixed-type gastric carcinoma in the context of its morphological histological tumor components, as well as the oncogenesis mechanisms are necessary, because they may help in diagnosing the tumor in its early stage and in predicting the outcome more accurately and choosing the appropriate management strategy, that is, determining the extent of the surgical manipulation and further drug therapy, taking into account tumor molecular characteristics and its PD-L1 status, which in the long run will significantly affect the five-year survival of the patients.