Abstract
The histological classification of gastric adenocarcinoma influences its prognostic outcomes and therapeutic strategies. Although fibroblast growth factor (FGF)10 is important for gastric morphogenesis, its use as a molecular marker of gland-forming differentiation pattern remains undefined. The present study examined 117 surgically resected gastric adenocarcinoma specimens using immunohistochemical analysis to evaluate the expression of FGF10 and FGF receptor 2 (FGFR2). Expression patterns in tumor cells and the surrounding stroma were assessed using a four-tier scale. Associations between marker expression and histological differentiation were analyzed by multivariable ordinal logistic regression, adjusting for age, human epidermal growth factor receptor 2 and epidermal growth factor receptor status. Elevated FGF10 expression was significantly associated with well-differentiated, gland-forming histological subtypes, particularly in moderately differentiated tubular adenocarcinoma [adjusted odds ratio (OR) in tumor cells: 1.749, 95% confidence interval (CI) 1.231-2.487, P=0.002; adjusted OR in stroma: 2.418, 95% CI 1.123-5.206, P=0.024]. Conversely, FGFR2 expression showed no association with differentiation pattern (adjusted OR: 0.908, 95% CI 0.452-1.824, P=0.788). Survival analysis revealed no significant relationship between FGF10 or FGFR2 expression level and overall patient survival [hazard ratio (HR) for FGF10 in tumor cells: 0.823, 95% CI 0.640-1.057, P=0.127; HR for FGF10 in stroma: 0.675, 95% CI 0.385-1.183, P=0.170; HR for FGFR2 in tumor cells: 1.080, 95% CI 0.559-2.085, P=0.819]. FGF10 may thus be a promising molecular marker of gland-forming differentiation pattern in gastric adenocarcinoma, offering valuable insights for refining its histopathological classification. These findings may contribute to the development of stratification biomarkers for personalized therapeutic approaches, particularly for the selection of molecular-targeted therapies. The absence of an association with overall survival, however, highlights the need for further investigations into the underlying mechanisms and their broader clinical significance.