{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T07:45:39Z","timestamp":1765525539738,"version":"3.48.0"},"reference-count":34,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T00:00:00Z","timestamp":1762732800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100007452","name":"Wu Jieping Medical Foundation","doi-asserted-by":"publisher","award":["320.6750.2020\u201011\u201034"],"award-info":[{"award-number":["320.6750.2020\u201011\u201034"]}],"id":[{"id":"10.13039\/100007452","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["pathsocjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Pathology"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Synchronous\/multifocal gastric\u2010type lesions (SMGLs) of the female genital tract are heterogeneous diseases that are rare and challenging to diagnose. The core issue is distinguishing between multiple primaries and multifocal metastases from a single lesion. This is vital for staging, prognosis, and treatment decisions, especially when metastases mimic primary and early lesions at the relevant sites. Traditional morphological diagnosis often faces a paradoxical situation on this key issue and cannot quantitatively evaluate the correlations among multiple foci. Here, six cases of SMGL were collected, two of which exhibited pagetoid dissemination within the genital tract, with all lesions being noninvasive. A total of 24 samples were subjected to whole\u2010exome sequencing. By inference based on overlapping genetic variations, base substitution mutation patterns, composition and similarity of COSMIC signatures, clonality indices, and the construction of evolutionary trees, it was inferred that the multiple foci in each patient were clonally related, indicating that all cases were metastatic. The follow\u2010up duration ranged from 7 to 62 months (median: 24.5 months). Four patients died of disease (median survival time: 24.5 months, range: 8\u201347 months), including one patient who had no invasive lesions at initial diagnosis; two patients experienced recurrences at 17 and 40 months, respectively. These results imply that even if all foci exhibit the appearance of\n                    <jats:italic>in situ<\/jats:italic>\n                    or premalignant changes histologically, they may actually be aggressive. Hence, for SMGLs, before opting for conservative treatment, comprehensive clinical assessment, appropriate surgical extent, adequate sampling, and careful microscopic examination are crucial. Clonal analysis should also be conducted where necessary to avoid undertreatment due to understaging. The study further explored the genomic traits of SMGLs involving more than two sites. \u00a9 2025 The Pathological Society of Great Britain and Ireland.\n                  <\/jats:p>","DOI":"10.1002\/path.6478","type":"journal-article","created":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T08:39:46Z","timestamp":1762763986000},"page":"27-39","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Molecular evidence of a clonal relationship of synchronous\/multifocal gastric\u2010type lesions of the female genital tract"],"prefix":"10.1002","volume":"268","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-4848-5164","authenticated-orcid":false,"given":"Min","family":"Shi","sequence":"first","affiliation":[{"name":"Department of Pathology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital &amp; Institute, Sichuan Cancer Center Affiliated Cancer Hospital of University of Electronic Science and Technology of China  Chengdu PR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-8921-0125","authenticated-orcid":false,"given":"Hong","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Pathology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital &amp; Institute, Sichuan Cancer Center Affiliated Cancer Hospital of University of Electronic Science and Technology of China  Chengdu PR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fang","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Pathology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital &amp; Institute, Sichuan Cancer Center Affiliated Cancer Hospital of University of Electronic Science and Technology of China  Chengdu PR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ting","family":"Hou","sequence":"additional","affiliation":[{"name":"Burning Rock Biotech  Guangzhou PR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huageng","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer Sun Yat\u2010sen University Cancer Center  Guangzhou PR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi","family":"Lu","sequence":"additional","affiliation":[{"name":"Burning Rock Biotech  Guangzhou PR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1480-1414","authenticated-orcid":false,"given":"Yehan","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Pathology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital &amp; Institute, Sichuan Cancer Center Affiliated Cancer Hospital of University of Electronic Science and Technology of China  Chengdu PR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ting","family":"Lan","sequence":"additional","affiliation":[{"name":"Department of Pathology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital &amp; Institute, Sichuan Cancer Center Affiliated Cancer Hospital of University of Electronic Science and Technology of China  Chengdu PR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan","family":"Ji","sequence":"additional","affiliation":[{"name":"Department of Pathology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital &amp; Institute, Sichuan Cancer Center Affiliated Cancer Hospital of University of Electronic Science and Technology of China  Chengdu PR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Hou","sequence":"additional","affiliation":[{"name":"Department of Pathology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital &amp; Institute, Sichuan Cancer Center Affiliated Cancer Hospital of University of Electronic Science and Technology of China  Chengdu PR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chengmin","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Pathology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital &amp; Institute, Sichuan Cancer Center Affiliated Cancer Hospital of University of Electronic Science and Technology of China  Chengdu PR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhou","family":"Zhang","sequence":"additional","affiliation":[{"name":"Burning Rock Biotech  Guangzhou PR 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China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6033-0648","authenticated-orcid":false,"given":"Yang","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Pathology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital &amp; Institute, Sichuan Cancer Center Affiliated Cancer Hospital of University of Electronic Science and Technology of China  Chengdu PR China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,11,10]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gore.2015.02.001"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2559.2008.03202.x"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4614-3165-7_18-2"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0000000000001039"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djv428"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djv427"},{"key":"e_1_2_9_8_1","first-page":"2207","article-title":"Synchronous endometrioid endometrial and ovarian carcinomas are biologically related: a clinico\u2010pathological and molecular (next generation sequencing) study of 22 cases","volume":"17","author":"H\u00e1jkov\u00e1 N","year":"2019","journal-title":"Oncol 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