Advances in Gastric Cancer Research: Insights Into Carcinogenesis, the Tumor Microenvironment, Metastasis, and Factors Influencing Prognosis

Abstract

Background

The Department of Gastroenterological Surgery at Kumamoto University has maintained a commitment to integrating cutting-edge clinical practice with fundamental research, particularly concerning malignant diseases of the digestive tract. This comprehensive review aimed to synthesize and consolidate the key clinical and translational research achievements published by our department, primarily focusing on gastric cancer (GC) and the pathophysiological mechanisms that drive its progression.

Methods

We systematically reviewed the most impactful English-language original research papers from our institution, since 2005. The identified studies span critical areas including molecular carcinogenesis, tumor microenvironment (TME) components, and mechanisms of systemic metastasis and drug resistance, and so on.

Results

Our accumulated research has yielded significant insights into the molecular basis of GC. A core area of contribution includes the genetic and epigenetic changes during carcinogenesis of gastric cancer or Gastric Adenocarcinoma and Proximal Polyposis of the Stomach (GAPPS), the tumor microenvironment (TME) especially focusing on Cancer-Associated Fibroblasts (CAFs), a factor promoting peritoneal dissemination of ECM-related genes and gut microbiota. Furthermore, our translational work has explored mechanisms of resistance to chemotherapeutic agents.

Conclusion

The collective research from our department represents a crucial contribution to the global understanding of gastric cancer pathogenesis, progression, and clinical management. These findings underscore our commitment to translating basic scientific discoveries into actionable strategies that advance individualized therapy, ultimately improving the long-term prognosis for patients with digestive malignancies.