Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
Department of Biochemistry, Keio University School of Medicine, Tokyo, Japan.
Gut Liver. 2021 Jan 15;15(1):3-12. doi: 10.5009/gnl19257.
Gastric cancer remains one of the most common causes of cancer-related death worldwide, although the incidence is declining gradually. The primary risk factor for gastric cancer is infection. The Kyoto global consensus report recommends eradication of in all infected patients. However, because it is difficult to stratify the risk of carcinogenesis among patients with a history of infection, annual endoscopic surveillance is performed for everyone after eradication. This review summarizes the current approaches used to screen for novel molecules that could assist in the diagnosis of gastric cancer and reduce mortality. Most well-studied molecules are tissue protein biomarkers expressed by the gastric epithelium and associated with metaplasia-dysplasia-carcinoma sequences. Other strategies focus on the origin of cancer stem cell-related markers, such as CD44, and immune reaction-related markers, such as matrix metallopeptidases. Noninvasive methods such as blood-based approaches are more attractive. Serum pepsinogen levels predict the severity of gastric mucosal atrophy before eradication, whereas plasma ghrelin levels are associated with atrophy even after eradication. Cell-free DNAs and RNAs are attractive tools for the early detection of cancer. These ideas could lead to the development of more personalized strategies for cancer prevention based on cutting-edge technologies.
胃癌仍然是全球癌症相关死亡的最常见原因之一，尽管发病率正在逐渐下降。胃癌的主要危险因素是 感染。《京都全球共识报告》建议在所有感染患者中根除 。然而，由于很难对 感染史患者的致癌风险进行分层，因此在根除后，所有人都要进行年度内镜监测。这篇综述总结了目前用于筛选新型分子的方法，这些分子可能有助于胃癌的诊断并降低死亡率。研究最多的分子是由胃上皮表达的组织蛋白生物标志物，与化生-异型增生-癌序列相关。其他策略侧重于与癌症干细胞相关的标记物的起源，如 CD44，以及与免疫反应相关的标记物，如基质金属蛋白酶。非侵入性方法，如基于血液的方法更具吸引力。血清胃蛋白酶原水平可预测 根除前胃黏膜萎缩的严重程度，而血浆 ghrelin 水平与根除后萎缩有关。游离 DNA 和 RNA 是癌症早期检测的有吸引力的工具。这些想法可能会导致基于前沿技术的更个性化的癌症预防策略的发展。
