胃肠道 (GI) 癌症在多个层面上具有高度异质性。肿瘤异质性可以通过分子分析来捕获，例如遗传、表观遗传、蛋白质组和转录组分类。转录组亚型分析的优点是结合了遗传和表观遗传信息、癌细胞内在特性和肿瘤微环境 (TME)。不同胃肠道恶性肿瘤的无监督转录组亚型系统引起了人们的兴趣，因为它们揭示了癌症之间共有的生物学特征，并具有预后和预测价值。重要的是，转录组亚型准确地反映了复杂的表型状态，不仅每个肿瘤区域不同，而且在整个疾病进展过程中也不同，这对临床治疗产生影响。在这里，我们讨论转录组亚型的方法、提出的胃肠道恶性肿瘤分类法以及临床实施所面临的挑战，强调未来转录组分析工作优化临床影响的机会。版权所有 © 2024 作者。由爱思唯尔公司出版。保留所有权利。

Gastrointestinal (GI) cancers are highly heterogeneous at multiple levels. Tumor heterogeneity can be captured by molecular profiling, such as genetic, epigenetic, proteomic, and transcriptomic classification. Transcriptomic subtyping has the advantage of combining genetic and epigenetic information, cancer cell-intrinsic properties, and the tumor microenvironment (TME). Unsupervised transcriptomic subtyping systems of different GI malignancies have gained interest because they reveal shared biological features across cancers and bear prognostic and predictive value. Importantly, transcriptomic subtypes accurately reflect complex phenotypic states varying not only per tumor region, but also throughout disease progression, with consequences for clinical management. Here, we discuss methodologies of transcriptomic subtyping, proposed taxonomies for GI malignancies, and the challenges posed to clinical implementation, highlighting opportunities for future transcriptomic profiling efforts to optimize clinical impact.Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.