Zheng Leizhen, Wang Liwei, Ajani Jaffer, Xie Keping
Department of Gastrointestinal Medical Oncology, Unit 426, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA.
Gastric Cancer. 2004;7(2):61-77. doi: 10.1007/s10120-004-0277-4.
Gastric cancer is one of the leading causes of cancer death worldwide. Because of its heterogeneity, gastric cancer has been an interesting model for studying carcinogenesis and tumorigenesis. Various genetic and molecular alterations are found in gastric cancer that underlie the malignant transformation of gastric mucosa during the multistep process of gastric cancer pathogenesis. Although the detailed mechanisms of gastric cancer development remain uncertain, the enhancement in understanding of its molecular biology in recent years has led to a better perspective on the molecular epidemiology, carcinogenesis, and pathogenesis of gastric cancer. More importantly, it is becoming possible to use molecular markers in differential diagnosis, prognostic evaluation, and specific clinical interventions. Because multiple molecular alterations are frequently noted in gastric cancer and because its histology is complex, new technologies for studying its molecular biology are important to further evaluate gastric carcinogenesis. This review describes our current knowledge of the molecular basis of gastric cancer as it relates to molecular epidemiology, multiple molecular alterations in pathogenesis, and molecular determinants of invasion and metastasis, as well as their potential clinical applications.
胃癌是全球癌症死亡的主要原因之一。由于其异质性，胃癌一直是研究致癌作用和肿瘤发生的一个有趣模型。在胃癌中发现了各种基因和分子改变，这些改变是胃癌发病多步骤过程中胃黏膜恶性转化的基础。尽管胃癌发生发展的详细机制仍不明确，但近年来对其分子生物学认识的提高，为胃癌的分子流行病学、致癌作用和发病机制提供了更好的视角。更重要的是，在鉴别诊断、预后评估和特定临床干预中使用分子标志物已成为可能。由于在胃癌中经常发现多种分子改变，且其组织学复杂，研究其分子生物学的新技术对于进一步评估胃癌发生发展很重要。本综述描述了我们目前对胃癌分子基础的认识，包括其与分子流行病学、发病机制中的多种分子改变、侵袭和转移的分子决定因素以及它们潜在的临床应用。
