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World Journal of Gastroenterology Jul 2018Gastric cancer (GC) is one of the most prevalent malignant types in the world and an aggressive disease with a poor 5-year survival. This cancer is biologically and... (Review)
Review
Gastric cancer (GC) is one of the most prevalent malignant types in the world and an aggressive disease with a poor 5-year survival. This cancer is biologically and genetically heterogeneous with a poorly understood carcinogenesis at the molecular level. Although the incidence is declining, the outcome of patients with GC remains dismal. Thus, the detection at an early stage utilizing useful screening approaches, selection of an appropriate treatment plan, and effective monitoring is pivotal to reduce GC mortalities. Identification of biomarkers in a basis of clinical information and comprehensive genome analysis could improve diagnosis, prognosis, prediction of recurrence and treatment response. This review summarized the current status and approaches in GC biomarker, which could be potentially used for early diagnosis, accurate prediction of therapeutic approaches and discussed the future perspective based on the molecular classification and profiling.
Topics: Antineoplastic Agents; Biomarkers, Tumor; Body Fluids; Carcinogenesis; Early Detection of Cancer; Gastrectomy; Gene Expression Profiling; Gene Expression Regulation, Neoplastic; Humans; Incidence; Liquid Biopsy; Neoplasm Recurrence, Local; Prevalence; Prognosis; Stomach; Stomach Neoplasms; Treatment Outcome
PubMed: 30018477
DOI: 10.3748/wjg.v24.i26.2818 -
Journal of Gastroenterology Aug 2022Gastric cancer (GC) is a major health concern in many countries. GC is a heterogeneous disease stratified by histopathological differences. However, these variations are... (Review)
Review
Gastric cancer (GC) is a major health concern in many countries. GC is a heterogeneous disease stratified by histopathological differences. However, these variations are not used to determine GC management. Next-generation sequencing (NGS) technologies have become widely used, and cancer genomic analysis has recently revealed the relationships between various malignant tumors and genomic information. In 2014, studies using whole-exome sequencing (WES) and whole-genome sequencing (WGS) for GC revealed the entire structure of GC genomics. Genomics with NGS has been used to identify new therapeutic targets for GC. Moreover, personalized medicine to provide specific therapy for targets based on multiplex gene panel testing of tumor tissues has become of clinical use. Recently, immune checkpoint inhibitors (ICIs) have been used for GC treatment; however, their response rates are limited. To predict the anti-tumor effects of ICIs for GC and to select patients suitable for ICI treatment, genomics also provides informative data not only of tumors but also of tumor microenvironments, such as tumor-infiltrating lymphocytes. In therapeutic strategies for unresectable or recurrent malignant tumors, the target is not only the primary lesion but also metastatic lesions, and metastatic lesions are often resistant to chemotherapy. Unlike colorectal carcinoma, there is a heterogeneous status of genetic variants between the primary and metastatic lesions in GC. Liquid biopsy analysis is also helpful for predicting the genomic status of both primary and metastatic lesions. Genomics has become an indispensable tool for GC treatment and is expected to be further developed in the future.
Topics: Genomics; High-Throughput Nucleotide Sequencing; Humans; Neoplasm Recurrence, Local; Precision Medicine; Stomach Neoplasms; Tumor Microenvironment
PubMed: 35751736
DOI: 10.1007/s00535-022-01879-3 -
Tumour Biology : the Journal of the... Jul 2017Gastric cancer is one of the most common malignant tumors in the digestive system. Surgery is currently considered to be the only radical treatment. As surgical... (Review)
Review
Gastric cancer is one of the most common malignant tumors in the digestive system. Surgery is currently considered to be the only radical treatment. As surgical techniques improve and progress is made in traditional radiotherapy, chemotherapy, and the implementation of neoadjuvant therapy, the 5-year survival rate of early gastric cancer can reach >95%. However, the low rate of early diagnosis means that most patients have advanced-stage disease at diagnosis and so the best surgical window is missed. Therefore, the main treatment for advanced gastric cancer is the combination of neoadjuvant chemoradiotherapy, molecular-targeted therapy, and immunotherapy. In this article, we summarize several common methods used to treat advanced gastric cancer and discuss the progress made in the treatment of gastric cancer in detail. Only clinical practice and clinical research will allow us to prolong the survival time of patients and allow the patients to truly benefit by paying attention to the individual patient characteristics, drug choice, and developing a reasonable and comprehensive treatment plan.
Topics: Combined Modality Therapy; Disease-Free Survival; Early Detection of Cancer; Gastrectomy; Humans; Molecular Targeted Therapy; Neoplasm Staging; Stomach Neoplasms
PubMed: 28671042
DOI: 10.1177/1010428317714626 -
Radiologia 2023Gastric cancer is the fifth most common cancer in the world. The most common histologic subtype is adenocarcinoma. Gastric adenocarcinomas are staged using the American... (Review)
Review
Gastric cancer is the fifth most common cancer in the world. The most common histologic subtype is adenocarcinoma. Gastric adenocarcinomas are staged using the American Joint Committee on Cancer's 8th TNM classification. The perigastric ligaments, mesentery, omentum, and potential spaces between the parietal and visceral peritoneal linings play are important structures for staging. The spread of disease is influenced by the location of the tumor within the stomach, as well as by the anatomy related to the ligaments and lymph vessels. CT is the imaging modality of choice for the preoperative clinical staging of gastric cancer, and it is essential for planning treatment. To be able to do an adequate imaging workup, radiologists need to know the different pathways through which gastric cancer can spread: lymphatic, subperitoneal, direct invasion, transperitoneal, hematogenous, and extramural venous invasion.
Topics: Humans; Neoplasm Staging; Stomach Neoplasms; Adenocarcinoma
PubMed: 36842787
DOI: 10.1016/j.rxeng.2022.10.011 -
Diagnostic and Interventional Radiology... May 2020Gastric cancer is the fifth most common malignancies and the third leading cause of cancer-related death worldwide, with more than 40% of new cases occurring in China.... (Comparative Study)
Comparative Study Review
Gastric cancer is the fifth most common malignancies and the third leading cause of cancer-related death worldwide, with more than 40% of new cases occurring in China. With the advancement of treatment methods, the application of adjuvant therapy and targeted drugs, the prognosis of patients with gastric cancer has been significantly improved. In recent years, more and more studies have reported that magnetic resonance imaging (MRI) showed great value in the clinical application among patients with gastric cancer, including preoperative staging, treatment response evaluation, predicting prognosis and histopathological features, treatment guidance, and molecular imaging. The remarkable research progress of MRI in gastric cancer will provide new evaluation and treatment approaches for clinical diagnosis and treatment. This article aims to review the current status of the application and research progress of MRI in patients with gastric cancer.
Topics: China; Clinical Decision Rules; Humans; Magnetic Resonance Imaging; Molecular Imaging; Neoplasm Staging; Practice Guidelines as Topic; Preoperative Period; Prognosis; Radiotherapy; Stomach Neoplasms; Treatment Outcome
PubMed: 32209504
DOI: 10.5152/dir.2019.19375 -
World Journal of Gastroenterology Feb 2016Gastric cancer currently ranks fourth in cancer-related mortality worldwide. In the western world, it is most often diagnosed at an advanced stage, after becoming... (Review)
Review
Gastric cancer currently ranks fourth in cancer-related mortality worldwide. In the western world, it is most often diagnosed at an advanced stage, after becoming metastatic at distant sites. Patients with advanced disease (locally advanced or metastatic) have a somber prognosis, with a median overall survival of 10-12 mo, and palliative chemotherapy is the mainstay of treatment. In recent years, novel approaches using inhibition of human epidermal growth factor receptor 2 (HER2) have demonstrated significant improvements in progression-free and overall survival, compared with chemotherapy alone, in first-line treatment of patients with overexpression of HER2. In addition, both second-line chemotherapy and treatment with the vascular endothelial growth factor receptor-inhibitor ramucirumab demonstrated significant benefits in terms of overall survival, compared with best supportive care, in randomized studies. Moreover, ramucirumab in combination with chemotherapy demonstrated further significant benefits in terms of progression-free and overall survival, compared with chemotherapy alone, in second-line treatment for patients with metastatic gastric cancer. A recently published molecular classification of gastric cancer is expected to improve patient stratification and selection for clinical trials and provide a roadmap for future drug development. Nevertheless, despite these developments the prognosis of patients with advanced gastric cancer remains poor. In this review we discuss current standards of care and outline major topics of drug development in gastric cancer.
Topics: Antineoplastic Combined Chemotherapy Protocols; Disease Progression; Disease-Free Survival; Drug Discovery; Genetic Predisposition to Disease; Humans; Molecular Diagnostic Techniques; Molecular Targeted Therapy; Neoplasm Staging; Palliative Care; Phenotype; Precision Medicine; Predictive Value of Tests; Risk Factors; Stomach Neoplasms; Time Factors; Treatment Outcome
PubMed: 26937129
DOI: 10.3748/wjg.v22.i8.2403 -
Molecular Cancer Mar 2020Gastric cancer is the fourth most common malignancy and the third leading cause of cancer-related deaths worldwide. Advanced gastric cancer patients can notably benefit... (Review)
Review
Gastric cancer is the fourth most common malignancy and the third leading cause of cancer-related deaths worldwide. Advanced gastric cancer patients can notably benefit from chemotherapy including adriamycin, platinum drugs, 5-fluorouracil, vincristine, and paclitaxel as well as targeted therapy drugs. Nevertheless, primary drug resistance or acquisition drug resistance eventually lead to treatment failure and poor outcomes of the gastric cancer patients. The detailed mechanisms involved in gastric cancer drug resistance have been revealed. Interestingly, different noncoding RNAs (ncRNAs), such as microRNAs (miRNAs), long noncoding RNAs (lncRNAs) and circular RNAs (circRNAs), are critically involved in gastric cancer development. Multiple lines of evidences demonstrated that ncRNAs play a vital role in gastric cancer resistance to chemotherapy reagents and targeted therapy drugs. In this review, we systematically summarized the emerging role and detailed molecular mechanisms of ncRNAs impact drug resistance of gastric cancer. Additionally, we propose the potential clinical implications of ncRNAs as novel therapeutic targets and prognostic biomarkers for gastric cancer.
Topics: Animals; Biomarkers, Tumor; Drug Resistance, Neoplasm; Gene Expression Regulation, Neoplastic; Humans; RNA, Long Noncoding; Stomach Neoplasms
PubMed: 32192494
DOI: 10.1186/s12943-020-01185-7 -
World Journal of Gastroenterology Oct 2014Gastric cancer continues to be an important healthcare problem from a global perspective. Most of the cases in the Western world are diagnosed at late stages when the... (Review)
Review
Gastric cancer continues to be an important healthcare problem from a global perspective. Most of the cases in the Western world are diagnosed at late stages when the treatment is largely ineffective. Helicobacter pylori (H. pylori) infection is a well-established carcinogen for gastric cancer. While lifestyle factors are important, the efficacy of interventions in their modification, as in the use of antioxidant supplements, is unconvincing. No organized screening programs can be found outside Asia (Japan and South Korea). Although several screening approaches have been proposed, including indirect atrophy detection by measuring pepsinogen in the circulation, none of them have so far been implemented, and more study data is required to justify any implementation. Mass eradication of H. pylori in high-risk areas tends to be cost-effective, but its adverse effects and resistance remain a concern. Searches for new screening biomarkers, including microRNA and cancer-autoantibody panels, as well as detection of volatile organic compounds in the breath, are in progress. Endoscopy with a proper biopsy follow-up remains the standard for early detection of cancer and related premalignant lesions. At the same time, new advanced high-resolution endoscopic technologies are showing promising results with respect to diagnosing mucosal lesions visually and targeting each biopsy. New histological risk stratifications (classifications), including OLGA and OLGIM, have recently been developed. This review addresses the current means for gastric cancer primary and secondary prevention, the available and emerging methods for screening, and new developments in endoscopic detection of early lesions of the stomach.
Topics: Biopsy; Early Detection of Cancer; Gastroscopy; Humans; Life Style; Neoplasm Staging; Precancerous Conditions; Predictive Value of Tests; Preventive Health Services; Risk Assessment; Risk Factors; Risk Reduction Behavior; Stomach Neoplasms
PubMed: 25320521
DOI: 10.3748/wjg.v20.i38.13842 -
Molecular Cancer Jul 2021Exosomes are a subpopulation of the tumour microenvironment (TME) that transmit various biological molecules to promote intercellular communication. Exosomes are derived... (Review)
Review
Exosomes are a subpopulation of the tumour microenvironment (TME) that transmit various biological molecules to promote intercellular communication. Exosomes are derived from nearly all types of cells and exist in all body fluids. Noncoding RNAs (ncRNAs) are among the most abundant contents in exosomes, and some ncRNAs with biological functions are specifically packaged into exosomes. Recent studies have revealed that exosome-derived ncRNAs play crucial roles in the tumorigenesis, progression and drug resistance of gastric cancer (GC). In addition, regulating the expression levels of exosomal ncRNAs can promote or suppress GC progression. Moreover, the membrane structures of exosomes protect ncRNAs from degradation by enzymes and other chemical substances, significantly increasing the stability of exosomal ncRNAs. Specific hallmarks within exosomes that can be used for exosome identification, and specific contents can be used to determine their origin. Therefore, exosomal ncRNAs are suitable for use as diagnostic and prognostic biomarkers or therapeutic targets. Regulating the biogenesis of exosomes and the expression levels of exosomal ncRNAs may represent a new way to block or eradicate GC. In this review, we summarized the origins and characteristics of exosomes and analysed the association between exosomal ncRNAs and GC development.
Topics: Animals; Biomarkers, Tumor; Disease Progression; Disease Susceptibility; Drug Resistance, Neoplasm; Epithelial-Mesenchymal Transition; Exosomes; Gene Expression Regulation, Neoplastic; Helicobacter Infections; Humans; Molecular Targeted Therapy; Neoplasm Metastasis; Neoplasm Staging; Prognosis; RNA, Untranslated; Stomach Neoplasms; Tumor Escape; Tumor Microenvironment
PubMed: 34330299
DOI: 10.1186/s12943-021-01396-6 -
Pathologica Sep 2020Gastric biopsies represent one of the most frequent specimens that the pathologist faces in routine activity. In the last decade or so, the landscape of gastric... (Review)
Review
Gastric biopsies represent one of the most frequent specimens that the pathologist faces in routine activity. In the last decade or so, the landscape of gastric pathology has been changing with a significant and constant decline of -related pathologies in Western countries coupled with the expansion of iatrogenic lesions due to the use of next-generation drugs in the oncological setting. This overview will focus on the description of the elementary lesions observed in gastric biopsies and on the most recent published recommendations, guidelines and expert opinions.
Topics: Biopsy; Endoscopy; Gastric Mucosa; Gastritis; Helicobacter pylori; Humans; Neoplasm Grading; Precancerous Conditions; Risk Factors; Stomach Neoplasms
PubMed: 33179619
DOI: 10.32074/1591-951X-163