Gastric carcinogenesis

Gastric cancer is a leading cause of cancer-related death, particularly in Asia. A number of risk factors associated with gastric carcinogenesis have been identified by epidemiological, clinical, and molecular studies. Several epigenetic and proteomic modulations are known to be primary drivers promoting carcinogenesis and the progression of gastric cancer. In recent years, the role of these modulations in gastric carcinogenesis has been widely studied. Early gastric cancer can be treated and even completely cured surgically using endoscopic submucosal dissection (ESD). However, the prognosis of advanced or distantly metastasized gastric cancer is poor. Highly advanced gastric cancer is difficult to completely cure using chemotherapy. Therefore, prevention or early detection of gastric cancer is crucial. Understanding how epigenetic or proteomic modulations affect gastric carcinogenesis has importance in detecting, treating, and preventing gastric cancer. Further study is expected to provide us the basis for targeted molecular therapy or novel biomarkers that evaluate the prognosis or risk of gastric carcinogenesis. In this chapter, recent results of studies on epigenetic and proteomic modulations related to gastric carcinogenesis and clinical outcomes are described, with a special focus on Japanese research.