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Lauren Classification — SCE Medical Oncology MCQ

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ModerateGI CancersLauren ClassificationSCE Medical Oncology

A 65-year-old man with metastatic gastric cancer develops peritoneal carcinomatosis with malignant ascites. His primary tumour was diffuse (signet ring cell) type. What does Lauren classification indicate about prognosis?

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Correct answer: C — Diffuse-type gastric cancer has worse prognosis than intestinal-type

The Lauren classification divides gastric adenocarcinoma into intestinal (gland-forming, often distal, associated with H. pylori/intestinal metaplasia, better prognosis) and diffuse (non-cohesive/signet ring cells, often younger patients, linitis plastica, peritoneal tropism, worse prognosis). The molecular correlate is: intestinal ~ CIN/MSI subtypes; diffuse ~ GS (genomically stable) subtype with CDH1 loss. This classification remains clinically relevant for prognosis and treatment planning. Hereditary diffuse gastric cancer (CDH1 mutation) is the hereditary form of diffuse type.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/cancer