Siddavaram Nagini, Department of Biochemistry and Biotechnology, Faculty of Science, Annamalai University, Annamalainagar-608 002, Tamil Nadu, India.
World J Gastrointest Oncol. 2012 Jul 15;4(7):156-69. doi: 10.4251/wjgo.v4.i7.156.
Carcinoma of the stomach is still the second most common cause of cancer death worldwide, although the incidence and mortality have fallen dramatically over the last 50 years in many regions. The incidence of gastric cancer varies in different parts of the world and among various ethnic groups. Despite advances in diagnosis and treatment, the 5-year survival rate of stomach cancer is only 20 per cent. Stomach cancer can be classified into intestinal and diffuse types based on epidemiological and clinicopathological features. The etiology of gastric cancer is multifactorial and includes both dietary and nondietary factors. The major diet-related risk factors implicated in stomach cancer development include high content of nitrates and high salt intake. Accumulating evidence has implicated the role of Helicobacter pylori (H. pylori) infection in the pathogenesis of gastric cancer. The development of gastric cancer is a complex, multistep process involving multiple genetic and epigenetic alterations of oncogenes, tumor suppressor genes, DNA repair genes, cell cycle regulators, and signaling molecules. A plausible program for gastric cancer prevention involves intake of a balanced diet containing fruits and vegetables, improved sanitation and hygiene, screening and treatment of H. pylori infection, and follow-up of precancerous lesions. The fact that diet plays an important role in the etiology of gastric cancer offers scope for nutritional chemoprevention. Animal models have been extensively used to analyze the stepwise evolution of gastric carcinogenesis and to test dietary chemopreventive agents. Development of multitargeted preventive and therapeutic strategies for gastric cancer is a major challenge for the future.
胃癌仍然是全球第二大常见癌症死因，尽管在过去 50 年中，许多地区的发病率和死亡率已大幅下降。胃癌的发病率在世界不同地区和不同种族之间存在差异。尽管在诊断和治疗方面取得了进展，但胃癌的 5 年生存率仅为 20%。胃癌可根据流行病学和临床病理特征分为肠型和弥漫型。胃癌的病因是多因素的，包括饮食和非饮食因素。与胃癌发展相关的主要饮食相关危险因素包括硝酸盐含量高和高盐摄入。越来越多的证据表明，幽门螺杆菌（H. pylori）感染在胃癌的发病机制中起作用。胃癌的发生是一个复杂的、多步骤的过程，涉及癌基因、肿瘤抑制基因、DNA 修复基因、细胞周期调节剂和信号分子的多个遗传和表观遗传改变。一个合理的胃癌预防计划包括摄入含有水果和蔬菜的均衡饮食、改善卫生和卫生条件、筛查和治疗 H. pylori 感染以及随访癌前病变。饮食在胃癌病因学中起着重要作用，这为营养化学预防提供了可能性。动物模型已被广泛用于分析胃癌发生的逐步演变，并测试饮食化学预防剂。开发针对胃癌的多靶点预防和治疗策略是未来的主要挑战。
