Abstract
The most major biomarkers of gastric cancer are serum CEA and CA19-9, and they are increased in serum of adenocarcinoma patients. Both markers do not increase during early-stage carcinogenesis, so they are not useful for early diagnosis of gastric cancer. In the outpatient center after gastrectomy, however, simple biomarkers are still convenient, and serum RNA (microRNA and long noncoding RNA) biomarkers are newly emerging, as they exhibit higher sensitivity than the conventional serum markers. Gastric cancer is characterized by unique progression styles such as peritoneal dissemination, lymph node metastasis, and liver metastasis, which are consistent with macroscopic appearance of the tumors. Macroscopic type I/II gastric cancer tended to metastasize to liver, while type III/IV gastric cancer is prone to peritoneal dissemination. Increased trend of type III/IV gastric cancer has been lately recognized in developed countries, which has thus demanded diagnostic markers of peritoneal dissemination in gastric cancer clinics. Cytology test by microscopy is a gold standard for diagnosis of peritoneal remnant disease, but its sensitivity is insufficient because gastric cancer with negative cytology test frequently recurred in the peritoneum, especially in type III/IV gastric cancer. Highly sensitive biomarkers to detect minute peritoneal dissemination should be urgently required. Nevertheless, either CT or even PET-CT is unreliable to diagnose peritoneal recurrence even in combination with serum biomarkers, and the best tool to confirm the peritoneal recurrence is diagnostic laparoscopy at present. DNA markers using promoter DNA methylation of the tumor suppressor genes also have a great potential to detect early recurrence of the peritoneal dissemination on the diagnostic laparoscopy.
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Yamashita, K. (2019). Biomarkers in Gastric Cancer. In: Shimada, H. (eds) Biomarkers in Cancer Therapy. Springer, Singapore. https://doi.org/10.1007/978-981-13-7295-7_7
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DOI: https://doi.org/10.1007/978-981-13-7295-7_7
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