title: Molecular aspects in the diagnosis of gastric cancer.
abstract: BACKGROUND
  Gastric cancer (GC) represents the second most common cause of cancer-related death worldwide. The prognosis remains poor, with limited treatment options. A better understanding of the initiation and progression of GC would enable the development of general screening strategies and individualized treatment modalities.
  
  
  OBJECTIVE
  The assessment of tools and molecular markers for the early detection and diagnosis of GC.
  
  
  METHODS
  Human clinical studies published within the past 5 years are reviewed. Also, significant previous data on markers in clinical use or on relevant animal or cell culture experiments are considered.
  
  
  CONCLUSIONS
  Serum-based screening strategies are not ready for routine application but represent an opportunity for the identification of individuals at high risk with the need for primary gastroscopy and further surveillance, which would ultimately improve survival and prognosis of GC. Infection with Helicobacter pylori represents the principal risk factor for gastric carcinogenesis. Bacterial virulence and host genetic factors contribute to individual susceptibility. Key molecular alterations in gastric carcinogenesis are related to intra- and extracellular cascades that regulate cell proliferation, tumor invasion and metastastic spread. For the development of effective prevention and treatment modalities, it is essential to unravel the basic mechanisms of gastric carcinogenesis.
authors.affiliation: Otto-von-Guericke-University of Magdeburg, Department of Gastroenterology, Hepatology and Infectious Diseases, Leipziger Str. 44, D-39120 Magdeburg, Germany +0049 391 6713100 ; +0049 391 6713105 ; peter.malfertheiner@med.ovgu.de.
authors.forename: Jan
authors.initials: J
authors.lastname: Bornschein
authors.forename: Jochen
authors.initials: J
authors.lastname: Weigt
authors.forename: Michael
authors.initials: M
authors.lastname: Selgrad
authors.forename: Peter
authors.initials: P
authors.lastname: Malfertheiner