Carcinoma of the stomach: A review of epidemiology, pathogenesis, molecular genetics and chemoprevention
Carcinoma of the stomach: A review of epidemiology, pathogenesis, molecular genetics and chemoprevention
复制标题
DOI：
10.4251/wjgo.v4.i7.156
复制
发表时间：
2012-07-15
影响因子：
3
通讯作者：
Nagini, Siddavaram
中科院分区：
文献类型：
--
作者：
Nagini, Siddavaram
胃癌仍然是全世界癌症死亡的第二大常见原因，尽管过去50年来许多地区的发病率和死亡率急剧下降。胃癌的发病率在世界不同地区和不同民族之间有所不同。尽管在诊断和治疗方面取得了进步，但胃癌的5年生存率仅为20%。根据流行病学和临床病理特征，胃癌可分为肠型和弥漫型。胃癌的病因是多因素的，包括饮食和非饮食因素。与胃癌相关的主要饮食风险因素包括高硝酸盐含量和高盐摄入量。越来越多的证据表明幽门螺杆菌感染在胃癌发病机制中的作用。胃癌的发展是一个复杂的、多步骤的过程，涉及癌基因、肿瘤抑制基因、DNA修复基因、细胞周期调节因子和信号分子的多种遗传和表观遗传改变。一个合理的预防胃癌的方案包括摄入含有水果和蔬菜的均衡饮食，改善环境卫生和个人卫生，筛查和治疗幽门螺杆菌感染，以及对癌前病变的随访。事实上，饮食在胃癌的病因中起着重要作用，这为营养化学预防提供了空间。动物模型已被广泛用于分析胃癌发生的逐步演变和测试饮食化学预防药物。发展多靶点的胃癌预防和治疗策略是未来的主要挑战。(C) 2012年白石登。版权所有。
Carcinoma of the stomach is still the second most common cause of cancer death worldwide, although the incidence and mortality have fallen dramatically over the last 50 years in many regions. The incidence of gastric cancer varies in different parts of the world and among various ethnic groups. Despite advances in diagnosis and treatment, the 5-year survival rate of stomach cancer is only 20 per cent. Stomach cancer can be classified into intestinal and diffuse types based on epidemiological and clinicopathological features. The etiology of gastric cancer is multifactorial and includes both dietary and nondietary factors. The major diet-related risk factors implicated in stomach cancer development include high content of nitrates and high salt intake. Accumulating evidence has implicated the role of Heli-cobacter pylori (H. pylori) infection in the pathogenesis of gastric cancer. The development of gastric cancer is a complex, multistep process involving multiple genetic and epigenetic alterations of oncogenes, tumor suppressor genes, DNA repair genes, cell cycle regulators, and signaling molecules. A plausible program for gastric cancer prevention involves intake of a balanced diet containing fruits and vegetables, improved sanitation and hygiene, screening and treatment of H. pylori infection, and follow-up of precancerous lesions. The fact that diet plays an important role in the etiology of gastric cancer offers scope for nutritional chemoprevention. Animal models have been extensively used to analyze the stepwise evolution of gastric carcinogenesis and to test dietary chemopreventive agents. Development of multitargeted preventive and therapeutic strategies for gastric cancer is a major challenge for the future. (C) 2012 Baishideng. All rights reserved.