4. Stomach cancer biomarkers

Early diagnosis of gastric cancer is critical to improving treatment success. A variety of biomarkers play an important role in the early screening and diagnosis of gastric cancer, although they often need to be used in combination with other tests to improve accuracy. Some of the common markers are listed below:

Marker Definition Function Limitations
CA 19-9 A glycoprotein Used to detect tumors of the digestive system, including gastric cancer, and may be elevated especially in advanced gastric cancer Not specific, may be elevated in advanced stages and may be influenced by other factors
CEA Carcinoembryonic Antigen Expressed in a variety of cancers, including gastric cancer, for monitoring treatment efficacy and assessing the risk of recurrence Lacks specificity, may also be influenced by other non-cancer factors
CA 72-4 A glycoprotein Used as an aid in the diagnosis of gastric cancer, especially in advanced stages Not specific, may be elevated in other diseases
Pepsinogen Protease secreted by the gastric mucosa May be decreased in early gastric cancer and is considered an early diagnostic marker Interfered with by other gastric diseases and factors such as H. pylori infection
AFP Alpha-fetoprotein May be elevated in some rare types of gastric cancer Lacks specificity and is mainly used to detect specific subtypes of gastric cancer
MicroRNA A small molecule of RNA Studied as a potential diagnostic and therapeutic marker for gastric cancer in recent years Further research is needed for standardization of the technology and clinical validation

These markers play an important role in the early diagnosis of gastric cancer; however, they all have limitations and need to be fully evaluated in conjunction with other clinical information and tests.

Other gastric cancer research related genes include:

5. Metastatic mechanism

Metastasis of gastric cancer is the process of spreading cancer cells from the primary site to other sites, which usually involves several complex steps and interactive factors. The following is a detailed description of the mechanisms of gastric cancer metastasis:

Invasion and invasion: The first step in metastasis is the invasion of tumor cells from the primary site into surrounding tissues. This usually involves aggressive growth of tumor cells and invasion of surrounding structures. Cancer cells gain the ability to become invasive by altering the extracellular matrix and cell-cell interactions.

Intravascular metastasis: Once tumor cells have invaded surrounding tissues, they may enter the vascular system or the lymphatic system, spreading through the bloodstream or lymphatic fluids to sites distant from the primary site. This form of metastasis allows tumor cells to establish new foci farther away in the body.

Upstream Regulatory Genes: Abnormal expression or mutation of some genes plays a key role in the metastatic process. For example, inactivation of tumor suppressor genes (TSGs) and activation of tumor promoter genes (oncogene) may prompt tumor cells to metastasize.

Cell-cell interactions: Metastasis also involves the interaction of cancer cells with surrounding normal cells. This includes interactions with immune cells, vascular endothelial cells, etc., through which tumor cells evade immune surveillance and enter the blood or lymphatic system.

Microenvironmental Influences: The characteristics of the tumor microenvironment also influence the success of metastasis. Adequate angiogenesis, a suitable stromal environment, and the presence of immune cells may all play a key role in the development of metastasis.

New organ colonization: Once tumor cells reach a site far from the primary site, they need to colonize and grow in a new organ or tissue. This requires adaptation to the new microenvironment and interaction with surrounding cells.

Studying the mechanisms of metastasis in gastric cancer is crucial for developing prevention and treatment strategies and improving patient prognosis. A deeper understanding of these processes can help develop more targeted therapies to block or intervene in the metastatic process of cancer cells.

6. Recent advances in research

Advances in Surgical Treatment:

Despite the fact that 5-year survival rates for early gastric cancer can be more than 90%, the majority of patients still have predominantly advanced gastric cancer due to low rates of early diagnosis.Tan (2019) aims to provide an update on the latest advances in the surgical management of advanced gastric cancer [3].

Impact of eradication therapy on future gastric cancer risk:

Ford et al. (2020) assessed the impact of H. pylori eradication therapy on future gastric cancer risk in patients undergoing endoscopic mucosal resection for gastric tumors [4]. The study included 10 randomized controlled trials of more than 8000 healthy individuals and 1841 patients with gastric tumors.

Gastric Cancer Epidemiology and Screening for Prevention:

Gastric cancer is a global health problem, with more than 1 million people newly diagnosed with gastric cancer worldwide each year.Thrift et al. (2019) reviewed the epidemiology of gastric cancer, as well as screening and prevention efforts to reduce gastric cancer morbidity and mortality globally [5].Wong et al. (2021) analyzed data from global and national cancer registries, including 1980 to 2018 with incidence and mortality data for at least 15 calendar years. Overall, the incidence of gastric cancer has decreased in 29 countries and the mortality rate has decreased in 41 countries [6].Xie et al. (2021) reviewed the current epidemiologic status of gastrointestinal cancers in China, the United States, and Europe, the main risk factors and their distributions in these regions, and described current screening strategies. Gastrointestinal cancers such as gastric, colon, and esophageal cancers are a major medical and economic burden worldwide, with the highest number of new cancer cases and cancer deaths each year [8].

References

[1] Ferlay J, Shin HR, Bray F, et al. GLOBOCAN 2008 v2.0, cancer incidence and mortality worldwide: IARC CancerBase No. 10 [Internet]. Lyon (France): International gency for Research on Cancer, 2010.

[2] Jemal A, Bray F, Center MM, et al. Global cancer statistics [J]. CA Cancer J Clin 2011,61:69–90.

[3] Zhaoyang Tan. Recent Advances In The Surgical Treatment Of Advanced Gastric Cancer: A Review [J]. MEDICAL SCIENCE MONITOR , 2019.

[4] Alexander Charles Ford, Yuhong Yuan, Paul Moayyedi. Helicobacter Pylori Eradication Therapy to Prevent Gastric Cancer: Systematic Review and Meta-analysis [J]. GUT, 2020.

[5] Aaron P Thrift, Hashem B El-Serag, Burden of Gastric Cancer [J]. CLINICAL GASTROENTEROLOGY AND HEPATOLOGY, 2019.

[6] Martin C S Wong, Junjie Huang, Paul S F Chan, et al. Global Incidence and Mortality of Gastric Cancer, 1980-2018 [J]. JAMA NETWORK OPEN, 2021.

[7] Yumo Xie, Lishuo Shi, Xiaosheng He, Yanxin Luo. Gastrointestinal Cancers in China, The USA, and Europe [J]. GASTROENTEROLOGY REPORT, 2021.

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