Recent developments and innovations in gastric cancer

Abstract

Gastric cancer has an important place in the worldwide incidence of cancer and cancer-related deaths. It can metastasize to the lymph nodes in the early stages, and lymph node metastasis is an important prognostic factor. Surgery is a very important part of gastric cancer treatment. A D2 lymphadenectomy is the standard surgical treatment for cT1N+ and T2-T4 cancers, which are potentially curable. Recently, the TNM classification system was reorganized, and the margins for gastrectomy and lymphadenectomy were revised. Endoscopic, laparoscopic and robotic treatments of gastric cancer have progressed rapidly with development of surgical instruments and techniques, especially in Eastern countries. Different endoscopic resection techniques have been identified, and these can be divided into two main categories: endoscopic mucosal resection and endoscopic submucosal dissection. Minimally invasive surgery has been reported to be safe and effective for early gastric cancer, and it can be successfully applied to advanced gastric cancer with increasing experience. Cytoreductive surgery and hyperthermıc intraperıtoneal chemotherapy were developed as a combined treatment modality from the results of experimental and clinical studies. Also, hyperthermia increases the antitumor activity and penetration of chemotherapeutics. Trastuzumab which is a monoclonal antibody interacts with human epidermal growth factor (HER) 2 and is related to gastric carcinoma. The anti-tumor mechanism of trastuzumab is not clearly known, but mechanisms such as interruption of the HER2-mediated cell signaling pathways and cell cycle progression have been reported previously. H. pylori is involved in 90% of all gastric malignancies and Japanese guidelines strongly recommend that all H. pylori infections should be eradicated regardless of the associated disease. In this review, we present innovations discussed in recent studies.

Biochemical and structural characterization of a DNA N6-adenine methyltransferase fromHelicobacter pylori

“…Knockout of M1.HpyAVI largely prevents the growth of H. pylori [20]. Importantly, H. pylori is involved in 90% of all gastric malignancies [19]. Appropriate antibiotic regimens could successfully cure gastric diseases caused by H.pylori infection.…”

“…It is a major pathogen of gastritis and peptic ulcer diseases as well as a cancer-causing factor for gastric cancer. H. pylori is involved in 90% of all gastric malignancies, infecting nearly 50% of the world's population and is the most crucial etiologic agent for gastric adenocarcinoma [19]. H. pylori strains possess a few R-M systems like other bacteria to function as defensive systems.…”

PIAS1 inhibited the metastasis of gastric cancer cell by epithelial-mesenchymal transition regulation within the inflammatory microenvironment

“…To provide data that will enable the development of novel therapeutic strategies, it is crucial to elucidate the molecular mechanisms that promote the migration and invasion properties of gastric cancer. Metastasis is defined as the process of dissemination of cancer cells from their origin to a distant organ, a complex process involving several stages, which are as follows: i) The activation of EMT; ii) local invasion; iii) intravasation; iv) the ability to survive in the bloodstream; v) extravasation, whereby tumor cells exit the bloodstream; and vi) establishment of tumor cells in the tissues of a distant organ (16). EMT is a multistage reprogramming process that is also important in the physiological process of embryogenesis.…”

Downregulation of NPM expression by Her-2 reduces resistance of gastric cancer to oxaliplatin

“…Overexpression of Her-2 at the protein and/or mRNA level is detected in a variable percentage of cases, depending on the tumor (27)(28)(29). Furthermore, unlike breast cancer, previous studies have reported inconsistent findings regarding the prognostic role of Her-2 in gastric cancer (30)(31)(32). A previous study demonstrated that patients with intestinal-type and well-differentiated gastric cancer have a higher rate of Her-2 positivity than patients with diffuse-type and poorly-differentiated cancer (29).…”