Published online Dec 28, 2021. doi: 10.3748/wjg.v27.i48.8262
Peer-review started: March 25, 2021
First decision: June 26, 2021
Revised: July 2, 2021
Accepted: December 7, 2021
Article in press: December 7, 2021
Published online: December 28, 2021
Processing time: 273 Days and 14.1 Hours
Gastric cancer (GC) remains a serious oncological problem, ranking third in the structure of mortality from malignant neoplasms. Improving treatment outcomes for this pathology largely depends on understanding the pathogenesis and biological characteristics of GC, including the identification and characterization of diagnostic, prognostic, predictive, and therapeutic biomarkers. It is known that the main cause of death from malignant neoplasms and GC, in particular, is tumor metastasis. Given that angiogenesis is a critical process for tumor growth and metastasis, it is now considered an important marker of disease prognosis and sensitivity to anticancer therapy. In the presented review, modern concepts of the mechanisms of tumor vessel formation and the peculiarities of their morphology are considered; data on numerous factors influencing the formation of tumor microvessels and their role in GC progression are summarized; and various approaches to the classification of tumor vessels, as well as the methods for assessing angiogenesis activity in a tumor, are highlighted. Here, results from studies on the prognostic and predictive significance of tumor microvessels in GC are also discussed, and a new classification of tumor microvessels in GC, based on their morphology and clinical significance, is proposed for consideration.
Core Tip: In this review, data on the factors associated with the activation of angiogenesis in tumors, the mechanisms of tumor microvessel formation and the features of their morphology, methods for assessing the activity of angiogenesis in a tumor, and their role in the progression of gastric cancer (GC) are discussed. A new classification of tumor microvessels in GC based on their morphology and clinical significance is proposed. Considering the different types of tumor microvessels can have different sensitivities to antiangiogenic therapy, further study of their prognostic and predictive value is undoubtedly relevant.