Gastric Cancer: Early detection of disease, relapse and prediction of extent of disease

胃癌（GC）是世界上第二常见的癌症原因。胃癌的主要治疗方法是手术切除，但尽管手术干预措施有所改善，但死亡率仍然很高。胃癌5年生存率约为30%以上。准确的分期是胃癌管理的基础，目前的调查是不充分的。通过测量数千个基因的活性来确定哪些基因可以预测病人的生存或死于疾病，这已经成为可能。我们建议使用基因表达谱来预测胃癌患者复发的风险。我们将检查270多个肿瘤，并使用一组独立的患者来评估这项测试。我们的目标是开发一种测试，以帮助临床医生决定进行手术切除的类型或是否给予辅助化疗。该测试还可以指导更具体的抗癌药物的使用。早期发现胃癌非常重要，因为早期胃癌患者预后较好。我们已经用微阵列分析了60多个胃癌肿瘤，并发现了肿瘤特异性表达的基因，这些基因是癌症标志物的潜在候选者。我们计划研究更多的胃癌病例，以发现更多的基因并验证我们的候选基因作为肿瘤标志物。我们还希望在患者血液中寻找识别GC的蛋白质模式，并使用这种模式来跟踪患者的治疗进展。

Gastric cancer (GC) is the second commonest cause of cancer in the world. The mainstay of treatment for GC is surgical resection, but despite improvements in surgical interventions the mortality rate remains high. The 5 year survival rate of GC is about 30% over 5 years. Accurate staging is fundamental to the management of GC and current investigations are inadequate. It has become possible to measure the activity of thousands of genes to identify those genes that predict whether a patient will survive or succumb to their disease. We propose to use gene expression profiling to predict the risk of recurrence of gastric cancer in patients. We will examine over 270 tumours and use an independent group of patients to evaluate the test. We aim to develop a test that will help the clinician decide the type of surgical resection to perform or whether to give adjuvant chemotherapy. The test may also guide the use of more specific anticancer drugs. Early detection of GC is very important because patients with early stage GC have better outcome. We have already analysed over 60 GC tumours with microarrays and found genes that are specifically expressed by the tumours that are potential candidates as cancer markers. We plan to examine more cases of GC, both to find more genes and validate our candidate genes as tumour markers. We also want to look for patterns of proteins in blood of patients that identifies GC and use this pattern to follow patient progress to treatment.