Department of Gastrointestinal Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China.
German Cancer Research Center (DKFZ), Heidelberg, Germany.
Front Med. 2017 Mar;11(1):20-31. doi: 10.1007/s11684-016-0493-4. Epub 2017 Mar 2.
To date, gastric carcinoma (GC) is one of the common and fatal digestive malignancies worldwide. The prognosis of GC is not always satisfactory because of late diagnosis. Scholars are keen on discovering novel accurate and economical biomarkers in body liquids for GC screening to detect and evaluate the lesion before the results of imaging techniques are obtained. While traditional serum assays have limited sensitivity and specificity, gastrointestinal juice may provide relevant specific biomarkers because of its close contact with the tumor. Herein, the current progress in the relationship between gastrointestinal fluid analyses and GC is systematically and comprehensively reviewed. The detection of gastric juice pH, fluorescence spectrum, cytology, Helicobacter pylori-associated markers, nitrosamines, conventional tumor markers, amino acids, proteomics, microRNAs, long noncoding RNAs, protein-coding genes, vitamin C, etc., and combination tests of different category markers could provide important diagnostic and prognostic clues for gastrointestinal diseases. Particularly, early GC may be efficiently screened using gastric juice. Gastrointestinal fluid examination could also predict the adverse effects of postgastrectomy, such as pancreatic leakage, fistula, and abscess. Gastric fluid markers should be further studied to reveal the early predicators of malignancy and complications. The methods for obtaining the samples of gastrointestinal juice with minimum incision should also be comprehensively investigated.
迄今为止，胃癌（GC）是全球常见且致命的消化系统恶性肿瘤之一。由于诊断较晚，GC 的预后并不总是令人满意。学者们热衷于在体液中发现新型准确且经济的 GC 筛查生物标志物，以便在获得影像学技术结果之前检测和评估病变。虽然传统的血清检测具有有限的灵敏度和特异性，但由于胃肠液与肿瘤密切接触，可能提供相关的特异性生物标志物。在此，系统全面地综述了胃肠液分析与 GC 之间的当前研究进展。胃液 pH 值、荧光光谱、细胞学、幽门螺杆菌相关标志物、亚硝胺、常规肿瘤标志物、氨基酸、蛋白质组学、microRNAs、长链非编码 RNA、蛋白编码基因、维生素 C 等的检测，以及不同类别标志物的联合检测可为胃肠道疾病提供重要的诊断和预后线索。特别是，通过胃液可以有效地筛查早期 GC。胃肠液检查还可以预测胃切除术后的不良影响，如胰漏、瘘管和脓肿。还应进一步研究胃液标志物以揭示恶性和并发症的早期预测因子。还应全面研究以最小切口获得胃肠液样本的方法。
