Table 4. ACRG Subtypes.
| Subtypes | MSI GC | MSS/EMT GC | MSS/TP53- GC | MSS/TP53+ GC |
|---|---|---|---|---|
| Frequency | 22.7% | 15.3% | 35.7% | 26.3% |
| Demographic | Diagnosed at a significantly younger age | Male | Male | |
| Histology | Intestinal histology (> 60%) | Diffuse histology (> 80%) | Intestinal histology | Intestinal histology |
| Molecular alterations | Silencing of MLH1 gene | Loss of CDH1 | Highest prevalence of TP53 and RHOA mutations | Frequent EBV infection |
| Mutations in ARID1A, MTOR, KRAS, PIK3CA, ALK, PTEN | Loss of cellular adhesion, angiogenesis, motility | APC, ARID1A, KRAS, PIK3CA, SMAD4 enriched | Frequent mutations in ARID1A, PIK3CA, SMAD4, APC | |
| Overexpression of PD-L1 | ||||
| T cell infiltrate | ||||
| Prognosis | Best overall prognosis, lowest recurrence rate (22%) | Worst prognosis, highest recurrence rate | Intermediate | Intermediate |
ACRG: Asian Cancer Research Group; ARID1A: AT-rich interactive domain-containing protein 1A; CDH1: E-cadherin; GC: gastric cancer; MSS/EMT: microsatellite stable/epithelial-mesenchymal transition; MSS/TP53+: microsatellite stable/epithelial/TP53 intact; MSS/TP53-: microsatellite stable/epithelial/TP53 loss; MSI: microsatellite instability; PI3K: phosphatidylinositol-3-kinase; RHOA: Ras homolog family member A; PD-L1: programmed death ligand-1.