Exploring the molecular pathology and tumor microenvironment in gastric cancer liver metastasis

The liver is the most common metastatic site of gastric cancer, and liver metastasis is one of the leading causes of death in patients with gastric cancer, characterized by a complex and unique tumor microenvironment (TME). The molecular classification and pathological characteristics of gastric cancer provide a basis for its research and treatment. The dynamic remodeling mechanisms of the TME involve multiple aspects, including stromal cell reprogramming, immune microenvironment characteristics, and regulation of the extracellular matrix and mechanical forces. The clinical challenges of gastric cancer liver metastasis (GC-LM) are severe, and effective intervention strategies need to be proposed, including overcoming physical barriers, precision therapies targeting the microenvironment, and biomarker development. In the future, integrating multi-omics and spatial dynamic analyses and establishing a molecular pathology-clinical translation feedback loop will be essential directions and challenges in this field. This review summarizes the research progress on the TME of GC-LM from clinical molecular pathology to precision medicine, aiming to provide a theoretical basis and new insights for the precision therapy of GC-LM.