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Abstract
Gastric cancer (GC) is the second leading cause of cancer mortality and the fourth most commonly diagnosed malignant disease, with approximately 951,000 new cases diagnosed and approximately 723,000 cases of mortality each year. The highest mortality rate of GC is in East Asia, and the lowest is in North America. A large number of studies have demonstrated that GC patients are characterized by higher morbidity, metastasis rates, and mortality and lower early diagnosis rates, radical resection rates, and 5-year survival rates. All cases of GC can be divided into two important stages, namely, early- and advanced-stage GC, and the stage mainly determines the treatment strategy for and the therapeutic effect in GC patients. Patients with early-stage GC undergo radical surgery followed by chemotherapy, and the 5-year survival rate can be as high as 90%. However, patients with advanced-stage GC cannot undergo radical surgery because they are at risk for metastasis; therefore, they can choose only radiotherapy or chemotherapy and have a poor prognosis. Based on the lack of specific clinical manifestations and detection methods, most GC patients (>70%) are diagnosed in the advanced stage; therefore, continued efforts toward developing treatments have been focused on advanced-stage GC patients and include molecular targeted therapy, immunotherapy, and small molecular therapy. Nevertheless, in recent years, accumulating evidence has indicated that small molecules, especially long noncoding RNAs (lncRNAs), are involved in the occurrence, development, and progression of GC, and their abundantly dysregulated expression has been identified in GC tissues and cell lines. Therefore, lncRNAs are considered easily detectable molecules and ideal biomarkers or target-specific agents for the future diagnosis or treatment of GC. In this review, we primarily discuss the status of GC, the role of lncRNAs in GC, and the emerging systemic treatments for GC.
Highlights
Accumulating evidence has demonstrated that many risk factors are implicated in the carcinogenesis and progression of Gastric Cancer (GC), such as genetic factors, obesity, Helicobacter pylori infection, Epstein-Barr virus infection, unhealthy diet, hypoxic stress, smoking, pernicious anemia, and chronic atrophic gastritis [1, 6, 7]
LncRNAs are considered scaffold molecules that are equivalent to adaptors or assembly platforms that bring two or more proteins into discrete complexes and change the expression of these genes and their related genes [28, 30]. Based on their multifunctional regulatory mechanisms, long noncoding RNAs (lncRNAs) comprise a novel field of study that has gained attention and is attractive to the scientific community investigating the occurrence and development processes of human diseases, such as cardiovascular syndromes, diabetes, autoimmune diseases, nervous system disorders, and cancers [31, 32]
China is a country with a high GC morbidity rate, which accounts for one-half of the new cases worldwide, and most GC patients are diagnosed at an advanced stage after they have lost the best chance of successful surgical treatment, and their prognosis is extremely poor [1, 2]
Summary
LncRNAs are able to regulate gene expression at various levels, including at the epigenetic, transcriptional, posttranscriptional levels, and are involved in various pathophysiological processes, such as genetic imprinting, cell-directed differentiation, cell proliferation, the cell cycle, tumorigenesis, development of neurodegenerative diseases, development and differentiation of immune cells, and regulation of immune response [16, 17]. LncRNAs are considered scaffold molecules that are equivalent to adaptors or assembly platforms that bring two or more proteins into discrete complexes and change the expression of these genes and their related genes [28, 30] Based on their multifunctional regulatory mechanisms, lncRNAs comprise a novel field of study that has gained attention and is attractive to the scientific community investigating the occurrence and development processes of human diseases, such as cardiovascular syndromes, diabetes, autoimmune diseases, nervous system disorders, and cancers [31, 32]. GC-related lncRNAs serve as potential diagnostic markers and therapeutic targets in clinical applications [57]
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