Cancer types
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Understanding Cancer Types: A Comprehensive Overview
Molecular Classification of Cancer Types
Multiplatform Analysis of 12 Cancer Types
Recent studies have utilized multiplatform genomic and proteomic analyses to classify cancers beyond their tissue of origin. An integrative analysis of 3,527 specimens from 12 cancer types revealed 11 major subtypes, some of which converge across different tissues. For instance, lung squamous, head and neck, and a subset of bladder cancers form a common subtype characterized by TP53 alterations and high expression of immune and proliferation pathway genes. This classification provides independent prognostic information and supports novel therapeutic strategies.
Cell-of-Origin Patterns in Cancer Classification
A comprehensive analysis of 10,000 tumors from 33 cancer types emphasized the dominant role of cell-of-origin patterns in molecular classification. This study found that molecular similarities among histologically or anatomically related cancer types could inform pan-cancer analyses, such as pan-gastrointestinal or pan-gynecological cancers, which may guide future therapeutic developments.
Proteomic Characterization of Cancer Subtypes
Proteomic profiling using mass spectrometry has identified ten proteome-based, pan-cancer subtypes across six tissue types. These subtypes, which include immune system involvement and tumor stroma characteristics, provide insights that are not always apparent through transcriptomics alone. This approach highlights the potential for discovering new therapeutic targets based on proteomic data.
Specific Cancer Types and Their Subtypes
Endometrial Cancer: Type I and Type II
Endometrial cancers are traditionally divided into estrogen-dependent Type I and estrogen-independent Type II. However, recent pooled analyses suggest that both types share many common risk factors, such as parity, oral contraceptive use, and smoking. Notably, body mass index has a greater effect on Type I tumors. These findings challenge the notion that Type II tumors are completely estrogen-independent .
Non-Small Cell Lung Cancer (NSCLC)
Lung cancer, particularly NSCLC, is classified into squamous cell carcinoma, adenocarcinoma, and large cell carcinoma. Treatment strategies for NSCLC emphasize the importance of early diagnosis, smoking cessation, and a combination of surgery, chemotherapy, and radiation therapy. The new international TNM staging system plays a crucial role in guiding these treatments.
Gastric Cancer Subtypes
Gastric cancer is a heterogeneous disease with four molecular subtypes linked to distinct clinical outcomes. These include mesenchymal-like, microsatellite-unstable, TP53-active, and TP53-inactive subtypes. Each subtype is associated with specific molecular alterations and varying prognoses, providing a framework for targeted clinical and preclinical research.
Breast Cancer: Histological and Molecular Diversity
Breast cancer comprises multiple entities with distinct histological and biological features. Recent studies have identified genotypic-phenotypic correlations in special types of breast cancer, such as secretory carcinomas and adenoid cystic carcinomas. These findings underscore the importance of considering histological types in the molecular taxonomy of breast cancer for identifying novel therapeutic targets.
Immune Landscape of Cancer
Immune Subtypes Across Cancer Types
An extensive immunogenomic analysis of over 10,000 tumors identified six immune subtypes characterized by differences in macrophage or lymphocyte signatures, Th1:Th2 cell ratio, and other factors. These subtypes span multiple cancer types and influence prognosis, providing a resource for exploring tumor-immune interactions and advancing immunotherapy research.
Conclusion
The classification of cancer types has evolved significantly with advances in genomic, proteomic, and immunogenomic analyses. These studies reveal that cancers can be classified based on molecular subtypes that cut across traditional tissue-of-origin boundaries, providing new insights into their etiology, prognosis, and potential therapeutic targets. Understanding these classifications is crucial for developing personalized treatment strategies and improving patient outcomes.
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