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Only for medical professionals to read the reference gene methylation detection may become a new method for early gastric cancer screening.
China is one of the countries with the highest incidence of gastric cancer.
According to the 2015 China Cancer Data Report, my country’s estimated new cases of gastric cancer each year are as high as 679,000, accounting for 42.
6% of the world’s total, and 498,000 deaths, accounting for approximately 45.
0 of the world’s total.
%.
The prevention and treatment of gastric cancer has become a public health issue of public concern.
At the 2021 Peking Union Medical College International Digestive Disease Forum and the 28th Peking Union Medical College Hospital Digestive Disease and Digestive Endoscopy Symposium, Professor Wu Kaichun from the Xijing Digestive Hospital of the Air Force Military Medical University discussed the topic of "early cancer, early treatment and early intervention", combining theory Actually, combined with clinical research, made a wonderful report! There are only five steps from gastritis to gastric cancer.
To stay away from the threat of gastric cancer, Professor Wu Kaichun pointed out that the occurrence of gastric cancer is divided into five parts: from normal tissues to precancerous lesions, early cancers, advanced cancers, and metastatic cancers.
We need us at every stage.
Facing it positively, early diagnosis and intervention are particularly important for the prognosis of patients.
Figure 1: The occurrence of gastric cancer is divided into five parts.
1 Primary prevention: Cause prevention and behavior intervention The causes of gastric cancer include internal factors, external factors, and disease factors.
Intrinsic factors: genetic susceptibility, blood type (A).
External factors: living and eating habits (smoked food, nitrite), environment, soil, water source.
Disease factors: gastric polyps, remnant stomach, gastric ulcer, Helicobacter pylori (Hp) infection, etc.
Hp infection is an important risk factor for gastric cancer, and its possible mechanism is: chronic inflammation caused by Hp→endogenous mutagenic gastric mucosal atrophy, intestinal metaplasia, dysplasia→carcinogenesis.
Hp can reduce nitrite, and nitroso compounds are recognized carcinogens; in addition, Hp metabolites can also promote epithelial cell mutation.
Figure 2: Hp is an important risk factor for gastric cancer 2 Secondary prevention: Early cancer diagnosis and endoscopic treatment Professor Wu Kaichun pointed out that the secondary prevention of gastric cancer can be mainly through the following three methods: endoscopy (detecting early gastric cancer); serum Markers (mostly found in advanced gastric cancer); imaging examination (mostly found in advanced gastric cancer).
3 Tertiary prevention: comprehensive treatment and molecular targeting The effect of gastric cancer treatment depends on whether it can be diagnosed early and correctly and choose the appropriate treatment.
Commonly used treatment methods include: surgery, chemotherapy (molecular targeting), radiotherapy, biological immunotherapy, traditional Chinese medicine treatment, etc.
Most stomach cancers are asymptomatic in the early stage.
How to achieve early diagnosis? The vast majority of gastric cancer has no obvious symptoms in the early stage, or only non-specific symptoms such as upper abdominal discomfort, acid reflux, belching, and loss of appetite occur, which are easy to be ignored.
Professor Wu Kaichun said that most of the current conventional protein markers are for patients with advanced gastric cancer.
For early gastric cancer, especially precancerous lesions, the detection rate of tumor markers is very low.
Therefore, there is an urgent need for us to find more tumor markers for early gastric cancer, so as to achieve early diagnosis and treatment, and bring more benefits to patients.
Commonly used markers include protein markers, circulating tumor cells, long non-coding RNA, exosomal circRNA, miRNA, circulating tumor DNA, etc.
The combined detection of multiple markers may be helpful in the diagnosis of early gastric cancer.
Figure 3: Selection of tumor markers.
Gene methylation is a chemical modification of genes, and it is also a landmark change in the early development of tumors.
Under the premise of not changing the gene sequence, changing the epigenetic inheritance changes the chromatin structure, DNA conformation, DNA stability and the way of interaction between DNA and protein, thereby regulating gene expression.
Gene methylation is an important mechanism of tumorigenesis, and may become a new method for early gastric cancer screening.
In recent years, gene methylation has received extensive attention from the medical community.
Figure 4: Gene methylation and tumorigenesis and development 1 RNF180 and Septin9 methylation can be used as serological diagnostic markers for gastric cancer.
RNF180 (ring finger protein 180) is a tumor suppressor gene.
RNF180 promoter methylation leads to low RNF180 in gastric cancer tissues Expression, promote the occurrence and proliferation of gastric cancer cells through multiple signal pathways such as HGF, CCR-7, MMP-2, and VEGF.
Septin9 is Septin and a tumor suppressor gene, encoding a conservative GTP-binding protein.
Septin9 is a protein that can bind to the cytoskeleton and is related to cell division and apoptosis.
If the Septin9 protein is unregulated, the structure of the Septin protein complex will lose stability, which will disrupt the cell division process and lead to cell cancer.
Studies have found that the methylated RNF180 and Septin9 genes are characteristically increased in plasma samples of gastric cancer patients.
Therefore, RNF180 and Septin9 methylation can be used as serological diagnostic markers for gastric cancer.
2RNF180/Septin9 Gene Methylation Detection Kit Professor Wu Kaichun introduced that the Fourth Military Medical University, the Chinese University of Hong Kong and Beijing Boercheng Company jointly developed the RNF180/Septin9 gene methylation detection kit.
The detection rate of this kit in early gastric cancer is 5-10 times that of traditional tumor markers, which is of great significance for the screening of early gastric cancer.
Single-center testing found that the sensitivity of the kit for gastric cancer detection was 64.
0%, and the specificity was 87.
5%.
Figure 5: Single-center detection results.
Multi-center detection found that the sensitivity of the kit for detecting gastric cancer was 61.
76% and the specificity was 86.
56%.
Figure 6: Early intervention of multi-center testing results can improve the survival rate of patients.
What is the appropriate treatment? Professor Wu Kaichun pointed out that the prognosis of patients with gastric cancer depends on early and correct diagnosis and selection of appropriate treatment.
Surgical options for early gastric cancer include endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD).
Currently, ESD is recommended as the standard surgical method for the treatment of early gastric cancer under endoscopy.
In addition, eradicating Helicobacter pylori or reversing atrophy/intestinal metaplasia for patients with gastric mucosal precancerous lesions can help prevent gastric cancer, which is worthy of application and exploration.
Summary: Prevention is the best strategy to reduce the incidence and mortality of gastric cancer.
Maximizing the detection of early gastric cancer is currently the most effective means to reduce mortality.
Endoscopic screening and blood marker detection can improve early cancer detection and prevention.
Intervene early to improve the prognosis and survival rate of patients.
Expert profile Professor Kaichun Wu Chief physician, professor, doctoral supervisor, deputy dean of Xijing Hospital of Digestive Diseases, Air Force Military Medical University, deputy director of the Chinese Medical Association Gastroenterology Branch, and leader of the Inflammatory Bowel Disease Group Chinese Medical Doctor Association Gastroenterologist Branch Vice-Chairman, Chinese People's Liberation Army Gastroenterology Professional Committee, Chairman, Shaanxi Gastroenterology Society, Executive Director, Asia-Pacific Society of Gastroenterology, Executive Director, World Gastroenterology Society, Executive Director, Asian Inflammatory Bowel Disease Organization, Director
China is one of the countries with the highest incidence of gastric cancer.
According to the 2015 China Cancer Data Report, my country’s estimated new cases of gastric cancer each year are as high as 679,000, accounting for 42.
6% of the world’s total, and 498,000 deaths, accounting for approximately 45.
0 of the world’s total.
%.
The prevention and treatment of gastric cancer has become a public health issue of public concern.
At the 2021 Peking Union Medical College International Digestive Disease Forum and the 28th Peking Union Medical College Hospital Digestive Disease and Digestive Endoscopy Symposium, Professor Wu Kaichun from the Xijing Digestive Hospital of the Air Force Military Medical University discussed the topic of "early cancer, early treatment and early intervention", combining theory Actually, combined with clinical research, made a wonderful report! There are only five steps from gastritis to gastric cancer.
To stay away from the threat of gastric cancer, Professor Wu Kaichun pointed out that the occurrence of gastric cancer is divided into five parts: from normal tissues to precancerous lesions, early cancers, advanced cancers, and metastatic cancers.
We need us at every stage.
Facing it positively, early diagnosis and intervention are particularly important for the prognosis of patients.
Figure 1: The occurrence of gastric cancer is divided into five parts.
1 Primary prevention: Cause prevention and behavior intervention The causes of gastric cancer include internal factors, external factors, and disease factors.
Intrinsic factors: genetic susceptibility, blood type (A).
External factors: living and eating habits (smoked food, nitrite), environment, soil, water source.
Disease factors: gastric polyps, remnant stomach, gastric ulcer, Helicobacter pylori (Hp) infection, etc.
Hp infection is an important risk factor for gastric cancer, and its possible mechanism is: chronic inflammation caused by Hp→endogenous mutagenic gastric mucosal atrophy, intestinal metaplasia, dysplasia→carcinogenesis.
Hp can reduce nitrite, and nitroso compounds are recognized carcinogens; in addition, Hp metabolites can also promote epithelial cell mutation.
Figure 2: Hp is an important risk factor for gastric cancer 2 Secondary prevention: Early cancer diagnosis and endoscopic treatment Professor Wu Kaichun pointed out that the secondary prevention of gastric cancer can be mainly through the following three methods: endoscopy (detecting early gastric cancer); serum Markers (mostly found in advanced gastric cancer); imaging examination (mostly found in advanced gastric cancer).
3 Tertiary prevention: comprehensive treatment and molecular targeting The effect of gastric cancer treatment depends on whether it can be diagnosed early and correctly and choose the appropriate treatment.
Commonly used treatment methods include: surgery, chemotherapy (molecular targeting), radiotherapy, biological immunotherapy, traditional Chinese medicine treatment, etc.
Most stomach cancers are asymptomatic in the early stage.
How to achieve early diagnosis? The vast majority of gastric cancer has no obvious symptoms in the early stage, or only non-specific symptoms such as upper abdominal discomfort, acid reflux, belching, and loss of appetite occur, which are easy to be ignored.
Professor Wu Kaichun said that most of the current conventional protein markers are for patients with advanced gastric cancer.
For early gastric cancer, especially precancerous lesions, the detection rate of tumor markers is very low.
Therefore, there is an urgent need for us to find more tumor markers for early gastric cancer, so as to achieve early diagnosis and treatment, and bring more benefits to patients.
Commonly used markers include protein markers, circulating tumor cells, long non-coding RNA, exosomal circRNA, miRNA, circulating tumor DNA, etc.
The combined detection of multiple markers may be helpful in the diagnosis of early gastric cancer.
Figure 3: Selection of tumor markers.
Gene methylation is a chemical modification of genes, and it is also a landmark change in the early development of tumors.
Under the premise of not changing the gene sequence, changing the epigenetic inheritance changes the chromatin structure, DNA conformation, DNA stability and the way of interaction between DNA and protein, thereby regulating gene expression.
Gene methylation is an important mechanism of tumorigenesis, and may become a new method for early gastric cancer screening.
In recent years, gene methylation has received extensive attention from the medical community.
Figure 4: Gene methylation and tumorigenesis and development 1 RNF180 and Septin9 methylation can be used as serological diagnostic markers for gastric cancer.
RNF180 (ring finger protein 180) is a tumor suppressor gene.
RNF180 promoter methylation leads to low RNF180 in gastric cancer tissues Expression, promote the occurrence and proliferation of gastric cancer cells through multiple signal pathways such as HGF, CCR-7, MMP-2, and VEGF.
Septin9 is Septin and a tumor suppressor gene, encoding a conservative GTP-binding protein.
Septin9 is a protein that can bind to the cytoskeleton and is related to cell division and apoptosis.
If the Septin9 protein is unregulated, the structure of the Septin protein complex will lose stability, which will disrupt the cell division process and lead to cell cancer.
Studies have found that the methylated RNF180 and Septin9 genes are characteristically increased in plasma samples of gastric cancer patients.
Therefore, RNF180 and Septin9 methylation can be used as serological diagnostic markers for gastric cancer.
2RNF180/Septin9 Gene Methylation Detection Kit Professor Wu Kaichun introduced that the Fourth Military Medical University, the Chinese University of Hong Kong and Beijing Boercheng Company jointly developed the RNF180/Septin9 gene methylation detection kit.
The detection rate of this kit in early gastric cancer is 5-10 times that of traditional tumor markers, which is of great significance for the screening of early gastric cancer.
Single-center testing found that the sensitivity of the kit for gastric cancer detection was 64.
0%, and the specificity was 87.
5%.
Figure 5: Single-center detection results.
Multi-center detection found that the sensitivity of the kit for detecting gastric cancer was 61.
76% and the specificity was 86.
56%.
Figure 6: Early intervention of multi-center testing results can improve the survival rate of patients.
What is the appropriate treatment? Professor Wu Kaichun pointed out that the prognosis of patients with gastric cancer depends on early and correct diagnosis and selection of appropriate treatment.
Surgical options for early gastric cancer include endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD).
Currently, ESD is recommended as the standard surgical method for the treatment of early gastric cancer under endoscopy.
In addition, eradicating Helicobacter pylori or reversing atrophy/intestinal metaplasia for patients with gastric mucosal precancerous lesions can help prevent gastric cancer, which is worthy of application and exploration.
Summary: Prevention is the best strategy to reduce the incidence and mortality of gastric cancer.
Maximizing the detection of early gastric cancer is currently the most effective means to reduce mortality.
Endoscopic screening and blood marker detection can improve early cancer detection and prevention.
Intervene early to improve the prognosis and survival rate of patients.
Expert profile Professor Kaichun Wu Chief physician, professor, doctoral supervisor, deputy dean of Xijing Hospital of Digestive Diseases, Air Force Military Medical University, deputy director of the Chinese Medical Association Gastroenterology Branch, and leader of the Inflammatory Bowel Disease Group Chinese Medical Doctor Association Gastroenterologist Branch Vice-Chairman, Chinese People's Liberation Army Gastroenterology Professional Committee, Chairman, Shaanxi Gastroenterology Society, Executive Director, Asia-Pacific Society of Gastroenterology, Executive Director, World Gastroenterology Society, Executive Director, Asian Inflammatory Bowel Disease Organization, Director
