Caracterización morfológica y molecular de los adenocarcinomasgástricos en pacientes menores de 40 años.

Salma Sánchez F; Carolin Peña M; Nelsin Rodríguez L; Verónica Lockward G; Isabel Fernández G; Franchely Rosario P; Félix Contreras M

doi:10.66464/1y9gnr26

Authors

Salma Sánchez F Residente de medicina interna, Clínica Universitaria Unión Médica, Santiago de los Caballeros, República Dominicana https://orcid.org/0009-0006-4638-9420
Carolin Peña M Residente de medicina interna, Clínica Universitaria Unión Médica, Santiago de los Caballeros, República Dominicana https://orcid.org/0009-0004-7347-6883
Nelsin Rodríguez L Residente de medicina interna, Clínica Universitaria Unión Médica, Santiago de los Caballeros, República Dominicana https://orcid.org/0009-0004-9224-4041
Verónica Lockward G Gastroenteróloga, jefa de enseñanza de residencias médicas de Clínica Universitaria Unión Médica, Santiago de los Caballeros, República Dominicana https://orcid.org/0009-0002-4107-1756
Isabel Fernández G Laboratorio de Patología Contreras Robledo, Santiago de los Caballeros, República Dominicana y Facultad de Ciencias de la Salud PUCMM https://orcid.org/0009-0006-5684-0879
Franchely Rosario P Laboratorio de Patología Contreras Robledo, Santiago de los Caballeros, República Dominicana y Facultad de Ciencias de la Salud PUCMM https://orcid.org/0009-0003-1166-9260
Félix Contreras M Laboratorio de Patología Contreras Robledo, Santiago de los Caballeros, República Dominicana y Facultad de Ciencias de la Salud PUCMM https://orcid.org/0000-0003-1174-4788

Keywords:

gastric adenocarcinoma, biomarkers, immunohistochemistry

Abstract

Gastric adenocarcinoma is a major cause of cancer-related mortality worldwide. Although it predominantly affects older adults, an increasing number of cases have been reported in patients younger than 40 years, who often exhibit distinct clinicopathological features. Morphological and molecular characterization using biomarkers has become increasingly relevant for the diagnostic and therapeutic management of this population. Methods: An observational, retrospective, and descriptive study was conducted on gastric adenocarcinomas diagnosed in patients younger than 40 years between January 2015 and August 2025 at the Contreras Robledo Pathology Laboratory. Demographic, histopathological, and topographic variables were analyzed, together with the immunohistochemical expression of MMR proteins, HER2, PD-L1, and E-cadherin. Results: Of 439 gastric adenocarcinomas, 4% (n=16) occurred in young patients. The mean age was 34 years, with a predominance of males. The most frequent tumor locations were the antrum and gastric body. Diffuse-type adenocarcinoma was the predominant histological subtype (93.7%), and most tumors were poorly differentiated. Most cases were MMR-proficient, while one case showed loss of MLH1/PMS2 expression (6.25%). HER2 and PD-L1 positivity was identified in one case each. E-cadherin expression was observed in 56% of the evaluated cases. Conclusion: Gastric adenocarcinoma in patients younger than 40 years is uncommon but is associated with aggressive histological features and low expression of therapeutic biomarkers. Systematic morphological and molecular characterization may provide valuable information for clinical management.

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