胃癌相关肿瘤标志物:从早期诊断到疗效预测、治疗选择指导

Gastric Cancer Related Tumor Markers:from Early Diagnosis to Efficacy Prediction and Treatment Selection

世界范围内,胃癌发病广泛,侵袭性强,5年生存率低。但胃癌的生物学行为和遗传学性质都不明确,分子生物学水平上的致癌机制尚不清楚。虽然近年来胃癌发病率有下降趋势,但患者生存率仍不理想。因此,采取措施早期筛查、早诊断,选择合适的治疗方案进行早治疗,选取合适的检测手段进行有效监测随访,可以提高早诊率,改善预后,预测复发,评估治疗反应。生物标志物的检测指标可以量化,检测结果客观,可以用于反映生理机能、病理表现以及预测药物疗效,甚至可以用于指导用药。DNA、RNA、蛋白、外泌体等目前成为生物标志物的研究重点。鉴于此,本研究全面总结胃癌相关生物标志物在诊断、疗效预测、复发监测及随访等领域的研究进展,对胃癌中生物标志物的研究方向进行分类,综述各分类潜在有价值的候选分子或标本,探寻可能用于临床的标志物,以期为实现肿瘤的个体化治疗提供参考借鉴。

The morbidity and mortality of gastric cancer is high in the world.Gastric cancer is aggressive and invasive disease with a low 5-year survival rate.However,the biological behavior and genetic characteristics of gastric cancer are still ambiguous,and the carcinogenic mechanism at the molecular biological level is still not clear.Although the incidence of gastric cancer has decreased in recent years,the survival rate remains unsatisfactory.Therefore,measures should be taken for screening and early detection,appropriate treatment strategy should be taken for early treatment,suitable imaging and laboratory test should be selected for monitoring and follow-up,so as to increase the rate of early diagnosis,improve prognosis,predict relapse and evaluate therapeutic response.The detection indexes of biomarkers can be quantified,and the detection results can be used to reflect the physiological function,pathological performance and predict the efficacy of drugs,and even to guide drug use.DNA,RNA,protein and exosomes have become the research focus of biomarkers.In view of this,this study summarized current progress on gastric cancer related biomarker in the fields of diagnosis,efficacy prediction,recurrence monitoring and follow-up.Meanwhile,the research directions of biomarkers of gastric cancer ware classified,the potential valuable candidate molecules or specimens of each classification were summarized,and the potential biomarkers for clinical application were investigated,so as to provide reference for the realization of individualized treatment of gastric cancer.