Abstract
Background
Gastric cancer (GC) remains the fifth most common incident cancer with the highest incidence in East Asian countries and the third leading cause of cancer death worldwide. The causal association between non-cardia GC and Helicobacter pylori (H. pylori) has been firmly documented by clinical and epidemiological studies. According to the guidelines for diagnosis and treatment of H. pylori infection, eradication therapy is strongly recommended. Early detection of GC is critical and can save lives through rapid technological advancement. At present, endoscopy remains the most efficient technique. However, it is invasive and costs highly.
Methods
An extensive bibliographic search was performed via PubMed/Medline, Web of Science, and EBSCO host databases to select studies conducted within the past 8 years. Forty-six relevant analyses were encompassed in this review.
Results
Several non-invasive candidate biomarkers associated with H. pylori, divided into virulence markers, transcriptome markers, genomic markers, and inflammatory markers, have been shown to be potential predictors of GC at an early stage.
Conclusion
The discovery of non-invasive biomarkers offers new perspectives for screening, early detection, and monitoring of individuals at risk.
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23 January 2022
"EL" of 3rd author's name should be captured as Family name. Full family name should be "EL KADMIRI"
References
Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68:394–424.
Machlowska J, Baj J, Sitarz M, Maciejewski R, Sitarz R. Gastric cancer: epidemiology, risk factors, classification, genomic characteristics and treatment strategies. Int J Mol Sci. 2020;21.
Plummer M, Franceschi S, Vignat J, Forman D, de Martel C. Global burden of gastric cancer attributable to Helicobacter pylori. Int J Cancer. 2015;136:487–90.
Chang W-L, Yeh Y-C, Sheu B-S. The impacts of H. pylori virulence factors on the development of gastroduodenal diseases. J Biomed Sci. 2018;25:68.
Khatoon J, Rai RP, Prasad KN. Role of Helicobacter pylori in gastric cancer: updates. World J Gastrointest Oncol. 2016;8:147–58.
Amieva M, Peek RM. Pathobiology of Helicobacter pylori-induced gastric cancer. Gastroenterology. 2016;150:64–78.
Chey WD, Leontiadis GI, Howden CW, Moss SF. ACG Clinical guideline: treatment of Helicobacter pylori infection. Am J Gastroenterol. 2017;112:212–39.
Sakitani K, Nishizawa T, Arita M, Yoshida S, Kataoka Y, Ohki D, et al. Early detection of gastric cancer after Helicobacter pylori eradication due to endoscopic surveillance. Helicobacter. 2018;23:e12503.
Shichijo S, Hirata Y. Characteristics and predictors of gastric cancer after Helicobacter pylori eradication. World J Gastroenterol. 2018;24:2163–72.
Lee Y-C, Chiang T-H, Chou C-K, Tu Y-K, Liao W-C, Wu M-S, et al. Association between Helicobacter pylori eradication and gastric cancer incidence: a systematic review and meta-analysis. Gastroenterology. 2016;150:1113-1124.e5.
Wang Y-K, Kuo F-C, Liu C-J, Wu M-C, Shih H-Y, Wang SSW, et al. Diagnosis of Helicobacter pylori infection: current options and developments. World J Gastroenterol. 2015;21:11221–35.
Hatakeyama M. Structure and function of Helicobacter pylori CagA, the first-identified bacterial protein involved in human cancer. Proc Jpn Acad Ser B Phys Biol Sci. 2017;93:196–219.
Park JY, Forman D, Waskito LA, Yamaoka Y, Crabtree JE. Epidemiology of Helicobacter pylori and CagA-positive infections and global variations in gastric cancer. Toxins. 2018;10:163.
Takahashi-Kanemitsu A, Knight CT, Hatakeyama M. Molecular anatomy and pathogenic actions of Helicobacter pylori CagA that underpin gastric carcinogenesis. Cell Mol Immunol. 2020;17:50–63.
Gantuya B, Bolor D, Oyuntsetseg K, Erdene-Ochir Y, Sanduijav R, Davaadorj D, et al. New observations regarding Helicobacter pylori and gastric cancer in Mongolia. Helicobacter. 2018;23:e12491.
El Khadir M, Boukhris SA, Benajah D-A, Ibrahimi SA, Chbani L, Bouguenouch L, et al. Helicobacter pylori CagA EPIYA-C motifs and gastric diseases in Moroccan patients. Infect Genet Evol J Mol Epidemiol Evol Genet Infect Dis. 2018;66:120–9.
Khatoon J, Prasad KN, Prakash Rai R, Ghoshal UC, Krishnani N. Association of heterogenicity of Helicobacter pylori cag pathogenicity island with peptic ulcer diseases and gastric cancer. Br J Biomed Sci. 2017;74:121–6.
Saeidi Y, Pournajaf A, Gholami M, Hasannejad-Bibalan M, Yaghoubi S, Khodabandeh M, et al. Determination of Helicobacter pylori virulence-associated genes in duodenal ulcer and gastric biopsies. Med J Islam Repub Iran. 2017;31:95.
Raei N, Behrouz B, Zahri S, Latifi-Navid S. Helicobacter pylori infection and dietary factors act synergistically to promote gastric cancer. Asian Pac J Cancer Prev APJCP. 2016;17:917–21.
McClain MS, Beckett AC, Cover TL. Helicobacter pylori vacuolating toxin and gastric cancer. Toxins. 2017;9.
Baj J, Forma A, Sitarz M, Portincasa P, Garruti G, Krasowska D, et al. Helicobacter pylori virulence factors—mechanisms of bacterial pathogenicity in the gastric microenvironment. Cells. 2020;10:27.
Caston RR, Sierra JC, Foegeding NJ, Truelock MD, Campbell AM, Frick-Cheng AE, et al. Functional properties of Helicobacter pylori VacA toxin m1 and m2 variants. Infect Immun. 2020;88:e00032-e120.
Winter JA, Letley DP, Cook KW, Rhead JL, Zaitoun AAM, Ingram RJM, et al. A role for the vacuolating cytotoxin, VacA, in colonization and Helicobacter pylori–induced metaplasia in the stomach. J Infect Dis. 2014;210:954–63.
El Khadir M, Alaoui Boukhris S, Benajah D-A, El Rhazi K, Ibrahimi SA, El Abkari M, et al. VacA and CagA status as biomarker of two opposite end outcomes of Helicobacter pylori infection (gastric cancer and duodenal ulcer) in a Moroccan population. PLoS One [Internet] [cited 1 Oct 2020] 2017;12. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5268467/
Liu X, He B, Cho WC, Pan Y, Chen J, Ying H, et al. A systematic review on the association between the Helicobacter pylori vacA i genotype and gastric disease. FEBS Open Bio. 2016;6:409–17.
Román-Román A, Martínez-Carrillo DN, Atrisco-Morales J, Azúcar-Heziquio JC, Cuevas-Caballero AS, Castañón-Sánchez CA, et al. Helicobacter pylori vacA s1m1 genotype but not cagA or babA2 increase the risk of ulcer and gastric cancer in patients from Southern Mexico. Gut Pathog. 2017;9:18.
Abdi E, Latifi-Navid S, Zahri S, Yazdanbod A, Safaralizadeh R. Helicobacter pylori genotypes determine risk of non-cardia gastric cancer and intestinal- or diffuse-type GC in Ardabil: a very high-risk area in Northwestern Iran. Microb Pathog. 2017;107:287–92.
Lin Z, Bian H, Chen C, Chen W, Li Q. Application of serum pepsinogen and carbohydrate antigen 72–4 (CA72-4) combined with gastrin-17 (G-17) detection in the screening, diagnosis, and evaluation of early gastric cancer. J Gastrointest Oncol. 2021;12:1042–8.
Yu H, Liu Y, Jiang S, Zhou Y, Guan Z, Dong S, et al. Serum pepsinogen II levels are doubled with Helicobacter pylori infection in an asymptomatic population of 40,383 Chinese subjects. Medicine (Baltimore). 2021;100:e26562.
Kurilovich S, Belkovets A, Reshetnikov O, Openko T, Malyutina S, Ragino Y, et al. Stomach-specific biomarkers (GastroPanel) can predict the development of gastric cancer in a Caucasian population: a longitudinal nested case-control study in Siberia. Anticancer Res. 2016;36:247–53.
Ikeda F, Shikata K, Hata J, Fukuhara M, Hirakawa Y, Ohara T, et al. Combination of Helicobacter pylori antibody and serum pepsinogen as a good predictive tool of gastric cancer incidence: 20-year prospective data from the Hisayama Study. J Epidemiol. 2016;26:629–36.
Tu H, Sun L, Dong X, Gong Y, Xu Q, Jing J, et al. A serological biopsy using five stomach-specific circulating biomarkers for gastric cancer risk assessment: a multi-phase study. Am J Gastroenterol. 2017;112:704–15.
Cai Q, Zhu C, Yuan Y, Feng Q, Feng Y, Hao Y, et al. Development and validation of a prediction rule for estimating gastric cancer risk in the Chinese high-risk population: a nationwide multicentre study. Gut. 2019;68:1576–87.
Wang R, Chen X-Z. Prevalence of atrophic gastritis in southwest China and predictive strength of serum gastrin-17: a cross-sectional study (SIGES). Sci Rep. 2020;10:4523.
Mnich E, Gajewski A, Rudnicka K, Gonciarz W, Stawerski P, Hinc K, et al. Immunoregulation of antigen presenting and secretory functions of monocytic cells by Helicobacter pylori antigens in relation to impairment of lymphocyte expansion. Acta Biochim Pol. 2015;62:641–50.
Rudnicka K, Miszczyk E, Matusiak A, Walencka M, Moran AP, Rudnicka W, et al. Helicobacter pylori-driven modulation of NK cell expansion, intracellular cytokine expression and cytotoxic activity. Innate Immun. 2015;21:127–39.
Li H, Liao T, Debowski AW, Tang H, Nilsson H-O, Stubbs KA, et al. Lipopolysaccharide structure and biosynthesis in Helicobacter pylori. Helicobacter. 2016;21:445–61.
Li N, Xu H, Ou Y, Feng Z, Zhang Q, Zhu Q, et al. LPS-induced CXCR7 expression promotes gastric cancer proliferation and migration via the TLR4/MD-2 pathway. Diagn Pathol. 2019;14:3.
Wang F, Mao Z, Liu D, Yu J, Wang Y, Ye W, et al. Overexpression of Tim-3 reduces Helicobacter pylori-associated inflammation through TLR4/NFκB signaling in vitro. Mol Med Rep. 2017;15:3252–8.
Jing Y, Guo S, Zhang X, Sun A, Tao F, Ju H, et al. Effects of small interfering RNA interference of connexin 37 on subcutaneous gastric tumours in mice. Mol Med Rep. 2014;10:2955–60.
Li H, Xu C-X, Gong R-J, Chi J-S, Liu P, Liu X-M. How does Helicobacter pylori cause gastric cancer through connexins: an opinion review. World J Gastroenterol. 2019;25:5220–32.
Li X, Zhou Z, Dou K, Wang Y. Connexin evolution ameliorates the risk of various cancers. Eur Rev Med Pharmacol Sci. 2015;19:1662–72.
Wu S-R, Wu Q, Shi Y-Q. Recent advances of miRNAs in the development and clinical application of gastric cancer. Chin Med J (Engl). 2020;133:1856–67.
Yang Q, Zhang R-W, Sui P-C, He H-T, Ding L. Dysregulation of non-coding RNAs in gastric cancer. World J Gastroenterol WJG. 2015;21:10956–81.
Shao L, Chen Z, Soutto M, Zhu S, Lu H, Romero-Gallo J, et al. Helicobacter pylori-induced miR-135b-5p promotes cisplatin resistance in gastric cancer. FASEB J Off Publ Fed Am Soc Exp Biol. 2019;33:264–74.
Zhu X-L, Ren L-F, Wang H-P, Bai Z-T, Zhang L, Meng W-B, et al. Plasma microRNAs as potential new biomarkers for early detection of early gastric cancer. World J Gastroenterol. 2019;25:1580–91.
Shi Y, Yang Z, Zhang T, Shen L, Li Y, Ding S. SIRT1-targeted miR-543 autophagy inhibition and epithelial-mesenchymal transition promotion in Helicobacter pylori CagA-associated gastric cancer. Cell Death Dis. 2019;10:625.
Wang F, Liu J, Zou Y, Jiao Y, Huang Y, Fan L, et al. MicroRNA-143–3p, up-regulated in H. pylori-positive gastric cancer, suppresses tumor growth, migration and invasion by directly targeting AKT2. Oncotarget. 2017;8:28711–24.
Prinz C, Weber D. MicroRNA (miR) dysregulation during Helicobacter pylori-induced gastric inflammation and cancer development: critical importance of miR-155. Oncotarget. 2020;11:894–904.
Link A, Kupcinskas J. MicroRNAs as non-invasive diagnostic biomarkers for gastric cancer: Current insights and future perspectives. World J Gastroenterol. 2018;24:3313–29.
Woo HD, Fernandez-Jimenez N, Ghantous A, Degli Esposti D, Cuenin C, Cahais V, et al. Genome-wide profiling of normal gastric mucosa identifies Helicobacter pylori- and cancer-associated DNA methylome changes. Int J Cancer. 2018;143:597–609.
Sepulveda JL, Gutierrez-Pajares JL, Luna A, Yao Y, Tobias JW, Thomas S, et al. High-definition CpG methylation of novel genes in gastric carcinogenesis identified by next-generation sequencing. Mod Pathol Off J U S Can Acad Pathol Inc. 2016;29:182–93.
Liu D, Ma X, Yang F, Xiao D, Jia Y, Wang Y. Discovery and validation of methylated-differentially expressed genes in Helicobacter pylori- induced gastric cancer. Cancer Gene Ther. 2020;27:473–85.
Kim HJ, Kim N, Kim HW, Park JH, Shin CM, Lee DH. Promising aberrant DNA methylation marker to predict gastric cancer development in individuals with family history and long-term effects of H. pylori eradication on DNA methylation. Gastric Cancer Off J Int Gastric Cancer Assoc Jpn Gastric Cancer Assoc. 2021;24:302–13.
Wisnieski F, Santos LC, Calcagno DQ, Geraldis JC, Gigek CO, Anauate AC, et al. The impact of DNA demethylation on the upregulation of the NRN1 and TNFAIP3 genes associated with advanced gastric cancer. J Mol Med Berl Ger. 2020;98:707–17.
Ge Y, Ma G, Liu H, Lin Y, Zhang G, Du M, et al. MUC1 is associated with TFF2 methylation in gastric cancer. Clin Epigenetics. 2020;12:37.
Xie W, Zhou H, Han Q, Sun T, Nie C, Hong J, et al. Relationship between DLEC1 and PBX3 promoter methylation and the risk and prognosis of gastric cancer in peripheral blood leukocytes. J Cancer Res Clin Oncol. 2020;146:1115–24.
Lin S, Zhang Y, Hu Y, Yang B, Cui J, Huang J, et al. Epigenetic downregulation of MUC17 by H. pylori infection facilitates NF-κB-mediated expression of CEACAM1–3S in human gastric cancer. Gastric Cancer Off J Int Gastric Cancer Assoc Jpn Gastric Cancer Assoc. 2019;22:941–54.
Zhu S, Soutto M, Chen Z, Peng D, Romero-Gallo J, Krishna US, et al. Helicobacter pylori-induced cell death is counteracted by NF-κB-mediated transcription of DARPP-32. Gut. 2017;66:761–2.
Negovan A, Iancu M, Fülöp E, Bănescu C. Helicobacter pylori and cytokine gene variants as predictors of premalignant gastric lesions. World J Gastroenterol. 2019;25:4105–24.
He B, Pan B, Pan Y, Sun H, Xu T, Qin J, et al. IL-4/IL-4R and IL-6/IL-6R genetic variations and gastric cancer risk in the Chinese population. Am J Transl Res. 2019;11:3698–706.
Li T, Shao W, Li S, Ma L, Zheng L, Shang W, et al. H. pylori infection induced BMAL1 expression and rhythm disorder aggravate gastric inflammation. EBioMedicine. 2019;39:301–14.
Sánchez-Zauco N, Torres J, Gómez A, Camorlinga-Ponce M, Muñoz-Pérez L, Herrera-Goepfert R, et al. Circulating blood levels of IL-6, IFN-γ, and IL-10 as potential diagnostic biomarkers in gastric cancer: a controlled study. BMC Cancer. 2017;17:384.
Choi YJ, Kim N. Gastric cancer and family history. Korean J Intern Med. 2016;31:1042–53.
de Brito BB, da Silva FAF, Soares AS, Pereira VA, Santos MLC, Sampaio MM, et al. Pathogenesis and clinical management of Helicobacter pylori gastric infection. World J Gastroenterol. 2019;25:5578–89.
George S, Lucero Y, Torres JP, Lagomarcino AJ, O’Ryan M. Gastric damage and cancer-associated biomarkers in Helicobacter pylori-infected children. Front Microbiol. 2020;11:90.
Pasechnikov V, Chukov S, Fedorov E, Kikuste I, Leja M. Gastric cancer: prevention, screening and early diagnosis. World J Gastroenterol. 2014;20:13842–62.
Chmiela M, Karwowska Z, Gonciarz W, Allushi B, Stączek P. Host pathogen interactions in Helicobacter pylori related gastric cancer. World J Gastroenterol. 2017;23:1521–40.
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BOUBRIK, F., BELMOUDEN, A. & EL KADMIRI, N. Potential Non-invasive Biomarkers of Helicobacter pylori-Associated Gastric Cancer. J Gastrointest Canc 53, 1113–1120 (2022). https://doi.org/10.1007/s12029-021-00734-7
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DOI: https://doi.org/10.1007/s12029-021-00734-7