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Genetic analysis clarifies stomach cancer risk factors

Researchers have used genomic technologies to better understand intestinal metaplasia (IM), a known risk factor for gastric (stomach) cancer.

The research, which appears in the journal Cancer Cell, could also help detect patients with Helicobacter pylori infections, which are also linked to the disease.

Patients with IM are six times more likely to develop stomach cancer than those without. This study is part of an investigation to understand why some people develop stomach cancer, while others do not.

Stomach cancer is the third deadliest cancer in the world according to World Health Organization (WHO) statistics. The disease is believed to be caused by infection with Helicobacter pylori but is potentially treatable if detected early. Unfortunately, more than two-thirds of stomach cancer patients are only diagnosed at an advanced stage.

“Previous genetic studies on IM have mainly focused on patients who were already diagnosed with stomach cancer but these are limited in their ability to predict who are likely to develop the disease and how the disease will progress,” says Patrick Tan, co-lead investigator and professor at the Duke-National University of Singapore Medical School.

“This new study is the first to comprehensively map out the genetic changes in IM in a cohort of stomach cancer-free subjects, which helps us better predict the possible occurrence and progression of the disease,” Tan says.

Yeoh Khay Guan, co-lead investigator and deputy chief executive of the National University Health System as well as dean of the National University of Singapore Yong Loo Lin School of Medicine, adds, “Our study is the largest series of IM to be studied in detail by genetic analysis. These new findings help us understand why some people have a higher risk of progression to stomach cancer, and identify those who may benefit from closer follow-up to prevent cancer or to detect it early so that it can be cured.”

The researchers recruited among the nearly 3,000 participants of the Gastric Cancer Epidemiology Programme (GCEP) cohort, with the support of patients and doctors from four local public hospitals, to show that a comprehensive analysis of the genetic patterns of IM can predict its subsequent progression towards stomach cancer.

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The analysis also revealed patients remaining infected by Helicobacter pylori after antibiotic treatment, highlighting individuals who should then receive additional antibiotic therapy. The genetic analysis of IM helps to identify those with a higher risk of progression to stomach cancer, adding further information to what is available by microscopic examination alone.

The research team is using this new information to identify biomarkers that can be applied in future in the clinic to identify people who have a high risk of progression to stomach cancer.

Funding for the research came primarily from the National Research Foundation Singapore under the TCR (Translational and Clinical Research) Flagship Programme on stomach cancer and administered by the Singapore Ministry of Health’s National Medical Research Council and grant NMRC/STaR/0026/2015.

Source: National University of Singapore

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