Translational Medicine Unit, Instituto Oncologico Fundacion Arturo Lopez Perez, Santiago 7500000, Metropolitan region, Chile.
World J Gastroenterol. 2023 Apr 21;29(15):2222-2240. doi: 10.3748/wjg.v29.i15.2222.
Worldwide, gastric cancer (GC) is the fifth most commonly diagnosed malignancy. It has a reduced prevalence but has maintained its poor prognosis being the fourth leading cause of deaths related to cancer. The highest mortality rates occur in Asian and Latin American countries, where cases are usually diagnosed at advanced stages. Overall, GC is viewed as the consequence of a multifactorial process, involving the virulence of the () strains, as well as some environmental factors, dietary habits, and host intrinsic factors. The tumor microenvironment in GC appears to be chronically inflamed which promotes tumor progression and reduces the therapeutic opportunities. It has been suggested that inflammation assessment needs to be measured qualitatively and quantitatively, considering cell-infiltration types, availability of receptors to detect damage and pathogens, and presence or absence of aggressive strains. Gastrointestinal epithelial cells express several Toll-like receptors and determine the first defensive line against pathogens, and have been also described as mediators of tumorigenesis. However, other molecules, such as cytokines related to inflammation and innate immunity, including immune checkpoint molecules, interferon-gamma pathway and NETosis have been associated with an increased risk of GC. Therefore, this review will explore innate immune activation in the context of premalignant lesions of the gastric epithelium and established gastric tumors.
在全球范围内，胃癌（GC）是第五种最常见的恶性肿瘤。它的发病率虽然有所降低，但由于是癌症相关死亡的第四大主要原因，其预后仍然很差。死亡率最高的是亚洲和拉丁美洲国家，这些国家的病例通常在晚期诊断。总的来说，GC 被认为是多种因素共同作用的结果，包括（）菌株的毒力，以及一些环境因素、饮食习惯和宿主内在因素。GC 中的肿瘤微环境似乎长期处于炎症状态，这促进了肿瘤的进展，减少了治疗机会。有人提出，炎症评估需要定性和定量地测量，考虑细胞浸润类型、检测损伤和病原体的受体的可用性，以及是否存在侵袭性菌株。胃肠道上皮细胞表达多种 Toll 样受体，是抵御病原体的第一道防线，也被描述为肿瘤发生的介质。然而，其他分子，如与炎症和先天免疫相关的细胞因子，包括免疫检查点分子、干扰素-γ途径和 NETosis，与 GC 的风险增加有关。因此，本综述将探讨先天免疫激活在胃上皮前恶性病变和已建立的胃癌中的作用。
