Latin-America (LATAM) is the second region in gastric cancer incidence; gastric adenocarcinoma (GA) represents 95% of all cases. We provide a mutational landscape of GA highlighting a) germline pathogenic variants associated with hereditary GA, b) germline risk variants associated with sporadic GA, and c) somatic variants present in sporadic GA in LATAM, and analyze how this landscape can be applied for precision medicine. We found that Brazil, Chile, Colombia, Mexico, Peru, and Venezuela are the countries with more published studies from LATAM explicitly related to GA. Our analysis displayed that different germline pathogenic variants for the CDH1 gene have been identified for hereditary GA in Brazilian, Chilean, Colombian, and Mexican populations. An increased risk of developing somatic GA is associated with the following germline risk variants: IL-4, IL-8, TNF-α, PTGS2, NFKB1, RAF1, KRAS and MAPK1 in Brazilian; IL-10 in Chilean; IL-10 in Colombian; EGFR and ERRB2 in Mexican, TCF7L2 and Chr8q24 in Venezuelan population. The path from mutational landscape to precision medicine requires four development levels: 1) Data compilation, 2) Data analysis and integration, 3) Development and approval of clinical approaches, and 4) Population benefits. Generating local genomic information is the initial padlock to overcome to generate and apply precision medicine.

拉丁美洲（LATAM）是胃癌发病率排名第二的地区；胃腺癌 (GA) 占所有病例的 95%。我们提供了 GA 的突变景观，重点介绍了 a) 与遗传性 GA 相关的种系致病性变异，b) 与散发性 GA 相关的种系风险变异，以及 c) 拉丁美洲散发性 GA 中存在的体细胞变异，并分析了如何应用这种景观来实现精确性药品。我们发现巴西、智利、哥伦比亚、墨西哥、秘鲁和委内瑞拉是拉丁美洲发表与 GA 明确相关研究较多的国家。我们的分析表明，在巴西、智利、哥伦比亚和墨西哥人群中，已鉴定出CDH1基因的不同种系致病性变异可导致遗传性 GA。发生体细胞 GA 的风险增加与以下种系风险变异相关：巴西的IL-4、IL-8、TNF-α、PTGS2、NFKB1、RAF1、KRAS和MAPK1 ；IL-10智利语；IL-10哥伦比亚语；墨西哥人群中的EGFR和ERRB2，委内瑞拉人群中的TCF7L2和 Chr8q24。从突变景观到精准医学的道路需要四个发展层次：1）数据汇编，2）数据分析和整合，3）临床方法的开发和批准，以及4）人群利益。生成局部基因组信息是生成和应用精准医学需要克服的最初的锁。