Exploring Molecular Determinants of Long-Term Survival in Metastatic Gastric Cancer: An mRNA Expression Pilot Study

The prognosis of patients with metastatic gastric cancer (mGC) remains poor, with substantial interpatient variability in overall survival (OS). We analyzed tumor tissue from 35 patients with mGC, classified as long-term (n = 4), medium-term (n = 12) and short-term survivors (n = 19). NanoString-based mRNA profiling of Wnt/β-catenin-related genes was conducted in an exploratory, hypothesis-generating framework. Heatmap analysis revealed three expression clusters. Cluster 1 showed significant enrichment of CDH1, SRC, and WNT5A. Cluster 2 showed significant enrichment of MP2, ZEB1, MMP2, TIPE3, and RXRG, consistent with a more aggressive phenotype. Cluster 3 preferentially identified an exploratory molecular pattern that requires validation in larger independent cohorts.