胃癌遺伝子検査の現状と未来

Current Status and Outlook of Genetic Examination in Gastric Cancer

要旨●胃癌における分子異常の解析が進み，その腫瘍発生が明らかになった．胃癌は4つの分子異常に類型化され〔①CIN（chromosomal instability），②MSI（microsatellite instability），③GS（genomically stable），④EBV（Epstein-Barr virus-related cancer）〕，組織型との関連性も指摘される．また，分子異常を標的とする分子標的薬と分子異常を検索する方法であるコンパニオン診断の開発が進んできた．HER2発現はトラスツズマブ投与において重要な役割を担い，PD-1，PD-L1は胃癌の新しい分子ターゲットとなりうる．

　There has been recent progress in analyzing molecular abnormality in gastric cancer, and tumorigenesis has been revealed. Gastric cancer is classified into four molecular subtypes：chromosomal instability, microsatellite instability, genomically stable, and Epstein-Barr virus-related cancer. In addition, gastric cancer can be classified based on histological patterns. Another area that has shown progress is companion diagnosis, which is a method of searching molecular target drugs and molecular abnormalities. HER2 expression plays an important role in directing the use of the biologic agent trastuzumab, and using PD-1and PD-L1 as new immunologic targets for gastric cancer may improve survival rates.