Inflammation and detection: Rethinking the biomarker landscape in gastric cancer.

Abstract

Gastric carcinoma is a leading cause of cancer-related mortality worldwide, yet reliable noninvasive biomarkers for its early detection remain limited. As research continues to elucidate the inflammatory underpinnings of tumor initiation and progression, it has become increasingly clear that pro-inflammatory cytokines may hold promise as diagnostic adjuncts. Serum cytokines such as interleukin (IL)-1β, IL-6, IL-8, and interferon-gamma have been frequently reported as elevated in gastric cancer patients compared to healthy individuals. These molecules, known for their roles in modulating tumor-promoting inflammation, angiogenesis, and immune evasion, may serve as accessible indicators of disease presence or progression. Several studies have shown that individual cytokines, particularly IL-6 and IL-8, can achieve receiver operating characteristic curves and area under the curve values exceeding 0.70, suggesting reasonable diagnostic utility. We assess the comparative utility of individual cytokines versus multiplex panels, evaluate their roles in tumor biology and treatment resistance, and situate these findings within the broader inflammatory biomarker landscape. Limitations of the current literature, including small sample sizes, heterogeneity in study design, and lack of specificity, are critically discussed. We advocate for prospective, multicenter validation studies and highlight the promise of integrating inflammatory cytokine profiling into diagnostic algorithms. Composite cytokine panels may better reflect the complex immunobiology of tumor progression and offer a scalable, accessible adjunct to current gastric cancer screening strategies.