A Study of the Effectiveness of Apoptosis Biomarkers in the Diagnosis of Gastric Cancer in Kazakhstan: A Review of Systematic Evidence.

Background: Gastric cancer in Kazakhstan shows low survival rates due to late diagnosis. This study aimed to explore apoptosis biomarkers to improve early detection and diagnostic accuracy. By investigating biomarkers like p53, RAS, miRNAs, and inflammation markers, the study sought to identify potential indicators for better prognosis and survival outcomes.

Methods: This systematic review was conducted using the keywords "apoptosis biomarkers" OR "gastric cancer" AND "Kazakhstan" OR "Kazakhstani" in the PubMed and Google Scholar databases, yielding 2,025 records. After filtering, 24 studies were selected for analysis. Quality was assessed using the Newcastle-Ottawa Scale, and data were extracted and synthesized for critical findings.

Results: This systematic review on apoptosis biomarkers in gastric cancer diagnosis in Kazakhstan highlights key findings across diverse studies. Biomarkers with the strongest diagnostic potential include p53, RAS, miRNAs (e.g., miR-21, miR-34a), and inflammation markers like NLR (neutrophil-to-lymphocyte ratio), PLR (platelet-to-lymphocyte ratio), and SII (systemic immune-inflammation index). Cytokines, including IL-2 and TNF, were linked to prognosis. DNA repair markers such as γ-H2AX and 53BP1 correlated with improved survival rates. Male predominance was consistent, with 63.1% to 66.4% of participants being male. Key environmental risk factors include Helicobacter pylori infection and heavy metal contamination. Survival rates ranged from 7.3% (Stage IV) to 50.5% (Stage I). The study also observed a statistically significant reduction in mortality rates from 14.0 to 8.9 per 100,000 (p<0.001), reflecting improvements in cancer management and diagnostic interventions.

Conclusion: This review underscores the pivotal role of apoptosis biomarkers in gastric cancer diagnosis in Kazakhstan. Biomarkers such as p53, RAS, and inflammation indices are integral to prognosis. Personalized diagnostic approaches, early detection, and targeted treatments can significantly improve survival outcomes and cancer management in this population.