人表皮生长因子受体 2 (HER2)、程序性死亡配体 1 (PD-L1) 和微卫星 (MS) 状态是胃食管腺癌 (GEA) 中公认的生物标志物。然而，尚不清楚这些生物标志物的组合如何与临床病理因素和预后相关。这项回顾性研究包括 2012 年至 2022 年间在 MD 安德森癌症中心接受所有三种生物标志物（HER2、PD-L1 和 MS 状态）测试的基线转移性 GEA 患者。根据生物标志物概况的组合进行分层：三阴性(TN)、单阳性 (SP) 和多阳性 (MP)。使用生物标志物组合对临床病理因素和生存进行比较分析。在分析的 698 名 GEA 患者中，251 名 (36.0%) 被归类为 TN，334 名 (47.9%) 被归类为 SP，113 名 (16.1%) 被归类为 MP。 MP 组显示与食管肿瘤 (p< .001)、良好至中度分化 (p< .001) 以及印戒细胞缺失 (p< .001) 显着相关。在生存分析中，与其他组相比，MP 组的总生存期 (OS) 显着更长（MP 与 TN，p<0.001；MP 与 SP，p<0.001）。多变量 Cox 回归分析显示，MP 作为 OS 的独立阳性预后指标（风险比 = 0.63，p < .01）。我们的研究结果表明 MP 生物标志物与转移性 GEA 的良好预后相关。这些结果反映了临床实践，并为治疗方法和未来生物标志物如何影响治疗/预后提供了宝贵的见解。© 2024 UICC。

Human epidermal growth factor receptor-2 (HER2), programmed death-ligand 1 (PD-L1), and microsatellite (MS) status are well-established biomarkers in gastroesophageal adenocarcinomas (GEAs). However, it is unclear how the combination of these biomarkers is associated with clinicopathological factors and prognosis. This retrospective study included baseline metastatic GEA patients who were tested for all three biomarkers (HER2, PD-L1, and MS status) at the MD Anderson Cancer Center between 2012 and 2022. Stratification was performed according to the combination of biomarker profiles: triple negative (TN), single positive (SP), and multiple positive (MP). Comparative analyses of clinicopathological factors and survival using combinations of biomarkers were performed. Among the 698 GEA patients analyzed, 251 (36.0%) were classified as TN, 334 (47.9%) as SP, and 113 (16.1%) as MP. The MP group showed a significant association with tumors located in the esophagus (p < .001), well to moderate differentiation (p < .001), and the absence of signet ring cells (p < .001). In the survival analysis, MP group had a significantly longer overall survival (OS) compared to the other groups (MP vs. TN, p < .001 and MP vs. SP, p < .001). Multivariate Cox regression analysis revealed that MP serves as an independent positive prognostic indicator for OS (hazard ratio = 0.63, p < .01). Our findings indicate that MP biomarkers are associated with a favorable prognosis in metastatic GEA. These results are reflective of clinical practice and offer valuable insights into how therapeutics and future biomarkers could influence therapy/prognosis.© 2024 UICC.