Identification and validation of H. pylori-associated gastric cancer biomarkers in Chinese and German populations

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Gastric cancer (GC) is the third leading cause of cancer-related deaths worldwide, with incidence being especially high in Asia. The development of gastric tumors is a multifactorial process in which infection with Helicobacter pylori is the main risk factor, while the individual risk is modulated by genetic and epigenetic factors. The chronic infection activates a number of inflammatory signaling pathways and induces DNA damage, contributing to the development and progression of precursor gastric lesions to GC. Late detection due to the lack of efficient biomarkers for early diagnosis as well as limited therapeutic strategies are the major reasons for the low prognosis observed in GC patients. Different studies have aimed at identifying novel biomarkers to improve early detection by non-invasive means, however, no single marker with sufficient predictive power to identify early stages has been demonstrated so far. Thus, the identification of biomarkers is an important aspect to address this high medical need. Importantly, the detection of biomarkers by non-invasive methods is of major significance for general clinical practice, especially in countries where prevalence is high and gastroscopic screening is not readily available for the broad population. This situation is found in many Asian countries. Therefore, we aim at establishing a screening algorithm for GC associated with H. pylori infection based on a combination of biomarkers detectable in peripheral blood which can be utilized to screen populations at high risk. This predictive model might eventually represent a powerful tool with a major impact on GC morbidity and mortality.