Abstract
Simple SummaryThis paper reviewed an update on the molecular detection of gastric cancers, focusing on various diagnostic approaches, including nonblood analytes, specifically gastric juices or washes. This comprehensive review demonstrates how liquid biopsy may be beneficial in identifying and optimizing new diagnostic approaches for gastric cancer.Gastric cancer (GC) is a significant source of global cancer death with a high mortality rate, because the majority of patients with GC are diagnosed at a late stage, with limited therapeutic choices and poor outcomes. Therefore, development of minimally invasive or noninvasive biomarkers which are specific to GC is crucially needed. The latest advancements in the understanding of GC molecular landscapes and molecular biological methods have accelerated attempts to diagnose GC at an early stage. Body fluids, including peripheral blood, saliva, gastric juice/wash, urine, and others, can be a source of biomarkers, offering new methods for the early detection of GC. Liquid biopsy-based methods using circulating sources of cancer nucleic acids could also be considered as alternative strategies. Moreover, investigating gastric juices/washes could represent an alternative for the detection of GC via invasive biopsy. This review summarizes recently reported biomarkers based on DNA methylation, microRNA, long noncoding RNA, circular RNA, or extracellular vesicles (exosomes) for the detection of GC. Although the majority of studies have been conducted to detect these alterations in advanced-stage GC and only a few in population studies or early-stage GC, some biomarkers are potentially valuable for the development of novel approaches for an early noninvasive detection of GC.
Highlights
Gastric cancer (GC) is the fifth most frequently diagnosed cancer and the third cause of yearly cancer deaths (781,000 deaths) worldwide [1]
Methylation levels in the gastric mucosa of patients with multiple GCs were higher than in those of patients with single GC or non-GC individuals with H. pylori infection. These findings suggest that miR-34b/c methylation is implicated in a gastric epigenetic field defect and could be a promising biomarker to analyze the risk of multiple GCs
Plasma H19 levels were higher in GCs than that in non-GCs [73,74,75] and discriminated between early-stage GCs and non-GCs with an area under the curve (AUC) of 0.877, sensitivity of 86%, and specificity of 80% [73]
Summary
Gastric cancer (GC) is the fifth most frequently diagnosed cancer (one million new cases) and the third cause of yearly cancer deaths (781,000 deaths) worldwide [1]. It is a diverse cancer with various environmental etiologic factors and alternate tumorigenic pathways (Figure 1) [2,3]. One of its main etiologies is a persistent Helicobacter pylori (H. pylori) infection, but only a minor fraction of people with. H. pylori infection develop GC [4,5]. The combination of gastroscopy with biopsy remains the standard method for the screening and diagnosis of GC [6,7].
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