Abstract
Background: Gastric cancer is a heterogeneous malignant disease associated with environmental and genetic predisposing factors. While gastric cancer incidence and mortality fell greatly globally over the past decades, it remains the fourth cause of cancer-related death worldwide. Thus, prevention of gastric cancer is still a major strategy for improvement of gastric cancer prognosis. Summary:Helicobacter pylori infection has been demonstrated to be a major risk factor for the development of gastric cancer. Unhealthy diet and lifestyle, including high-salt food, smoking and drinking, are able to induce genotypic and phenotypic transformation of gastric epithelial cells. Gene mutations (such as E-cadherin) in stomach epithelial cells are major genetic causes for gastric cancer. The eradication of H. pylori has been demonstrated to be an effective approach for primary prevention of gastric cancer. Increased intake of a diet rich in vegetables and fresh fruits as well as smoking cessation have been shown to reduce the incidence of gastric cancer. The secondary prevention strategy is to screen premalignant gastric lesions by endoscopy. Biomarker tests are also reliable methods to identify gastric precancerous lesions. Endoscopy screening is still the gold standard for diagnosis of gastric cancer. Key Message:H. pylori infection, a diet rich in salted and/or smoked food and red meat, as well as gene mutations are major risk factors for the development of gastric cancer. Practical Implications: The eradication of H. pylori is a major primary preventive strategy of gastric cancer. A healthy lifestyle, including increased intake of a diet rich in fruit and vegetables, reduced intake of salted and smoked food and red meat, a reduction of alcohol intake as well as smoking cessation will be effective approaches for the prevention of gastric cancer.
References
1.
Chen WQ, Zheng RS, Zhang SW, Zeng HM, Zou XN: The incidences and mortalities of major cancers in China, 2010. Chin J Cancer 2014;33:402-405.
2.
Lauren P: The two histological main types of gastric carcinoma: diffuse and so-called intestinal-type carcinoma. An attempt at a histo-clinical classification. Acta Pathol Microbiol Scand 1965;64:31-49.
3.
Crew KD, Neugut AI: Epidemiology of gastric cancer. World J Gastroenterol 2006;12:354-362.
4.
Cancer incidence in five continents. Volume VII. IARC Sci Publ 1997;143:i-xxxiv, 1-1240.
5.
Strong VE, Wu AW, Selby LV, Gonen M, Hsu M, Song KY, Park CH, Coit DG, Ji JF, Brennan MF: Differences in gastric cancer survival between the U.S. and China. J Surg Oncol 2015;112:31-37.
6.
Bosetti C, Bertuccio P, Malvezzi M, Levi F, Chatenoud L, Negri E, La Vecchia C: Cancer mortality in Europe, 2005-2009, and an overview of trends since 1980. Ann Oncol 2013;24:2657-2671.
7.
Karimi P, Islami F, Anandasabapathy S, Freedman ND, Kamangar F: Gastric cancer: descriptive epidemiology, risk factors, screening, and prevention. Cancer Epidemiol Biomarkers Prev 2014;23:700-713.
8.
Forman D, Burley VJ: Gastric cancer: global pattern of the disease and an overview of environmental risk factors. Best Pract Res Clin Gastroenterol 2006;20:633-649.
9.
Jemal A, Siegel R, Ward E, Murray T, Xu J, Smigal C, Thun MJ: Cancer statistics, 2006. CA Cancer J Clin 2006;56:106-130.
10.
Park JY, von Karsa L, Herrero R: Prevention strategies for gastric cancer: a global perspective. Clin Endosc 2014;47:478-489.
11.
Isobe Y, Nashimoto A, Akazawa K, Oda I, Hayashi K, Miyashiro I, Katai H, Tsujitani S, Kodera Y, Seto Y, Kaminishi M: Gastric cancer treatment in Japan: 2008 annual report of the JGCA nationwide registry. Gastric Cancer 2011;14:301-316.
12.
Hamashima C, Shibuya D, Yamazaki H, Inoue K, Fukao A, Saito H, Sobue T: The Japanese guidelines for gastric cancer screening. Jpn J Clin Oncol 2008;38:259-267.
13.
Zheng L, Wu C, Xi P, Zhu M, Zhang L, Chen S, Li X, Gu J, Zheng Y: The survival and the long-term trends of patients with gastric cancer in Shanghai, China. BMC Cancer 2014;14:300.
14.
Eid R, Moss SF: Helicobacter pylori infection and the development of gastric cancer. N Engl J Med 2002;346:65-67.
15.
Kamangar F, Cheng C, Abnet CC, Rabkin CS: Interleukin-1B polymorphisms and gastric cancer risk - a meta-analysis. Cancer Epidemiol Biomarkers Prev 2006;15:1920-1928.
16.
Ishaq S, Nunn L: Helicobacter pylori and gastric cancer: a state of the art review. Gastroenterol Hepatol Bed Bench 2015;8(suppl 1):S6-S14.
17.
Asaka M, Takeda H, Sugiyama T, Kato M: What role does Helicobacter pylori play in gastric cancer? Gastroenterology 1997;113(6 suppl):S56-S60.
18.
An international association between Helicobacter pylori infection and gastric cancer. The EUROGAST Study Group. Lancet 1993;341:1359-1362.
19.
de Vries AC, Kuipers EJ: Epidemiology of premalignant gastric lesions: implications for the development of screening and surveillance strategies. Helicobacter 2007;12(suppl 2):22-31.
20.
Huang JQ, Sridhar S, Chen Y, Hunt RH: Meta-analysis of the relationship between Helicobacter pylori seropositivity and gastric cancer. Gastroenterology 1998;114:1169-1179.
21.
de Martel C, Ferlay J, Franceschi S, Vignat J, Bray F, Forman D, Plummer M: Global burden of cancers attributable to infections in 2008: a review and synthetic analysis. Lancet Oncol 2012;13:607-615.
22.
Buti L, Spooner E, van der Veen AG, Rappuoli R, Covacci A, Ploegh HL: Helicobacter pylori cytotoxin-associated gene A (CagA) subverts the apoptosis-stimulating protein of p53 (ASPP2) tumor suppressor pathway of the host. Proc Natl Acad Sci USA 2011;108:9238-9243.
23.
Gebert B, Fischer W, Haas R: The Helicobacter pylori vacuolating cytotoxin: from cellular vacuolation to immunosuppressive activities. Rev Physiol Biochem Pharmacol 2004;152:205-220.
24.
Saadat I, Higashi H, Obuse C, Umeda M, Murata-Kamiya N, Saito Y, Lu H, Ohnishi N, Azuma T, Suzuki A, Ohno S, Hatakeyama M: Helicobacter pylori CagA targets PAR1/MARK kinase to disrupt epithelial cell polarity. Nature 2007;447:330-333.
25.
Peek RM Jr, Vaezi MF, Falk GW, Goldblum JR, Perez-Perez GI, Richter JE, Blaser MJ: Role of Helicobacter pylori cagA(+) strains and specific host immune responses on the development of premalignant and malignant lesions in the gastric cardia. Int J Cancer 1999;82:520-524.
26.
Wiseman M: The second World Cancer Research Fund/American Institute for Cancer Research expert report. Food, nutrition, physical activity, and the prevention of cancer: a global perspective. Proc Nutr Soc 2008;67:253-256.
27.
Woo HD, Park S, Oh K, Kim HJ, Shin HR, Moon HK, Kim J: Diet and cancer risk in the Korean population: a meta-analysis. Asian Pac J Cancer Prev 2014;15:8509-8519.
28.
Fox JG, Dangler CA, Taylor NS, King A, Koh TJ, Wang TC: High-salt diet induces gastric epithelial hyperplasia and parietal cell loss, and enhances Helicobacter pylori colonization in C57BL/6 mice. Cancer Res 1999;59:4823-4828.
29.
Cohen AJ, Roe FJ: Evaluation of the aetiological role of dietary salt exposure in gastric and other cancers in humans. Food Chem Toxicol 1997;35:271-293.
30.
Furihata C, Ohta H, Katsuyama T: Cause and effect between concentration-dependent tissue damage and temporary cell proliferation in rat stomach mucosa by NaCl, a stomach tumor promoter. Carcinogenesis 1996;17:401-406.
31.
Tsugane S, Sasazuki S, Kobayashi M, Sasaki S: Salt and salted food intake and subsequent risk of gastric cancer among middle-aged Japanese men and women. Br J Cancer 2004;90:128-134.
32.
Gaddy JA, Radin JN, Loh JT, Zhang F, Washington MK, Peek RM Jr, Algood HM, Cover TL: High dietary salt intake exacerbates Helicobacter pylori-induced gastric carcinogenesis. Infect Immun 2013;81:2258-2267.
33.
Kato S, Tsukamoto T, Mizoshita T, Tanaka H, Kumagai T, Ota H, Katsuyama T, Asaka M, Tatematsu M: High salt diets dose-dependently promote gastric chemical carcinogenesis in Helicobacter pylori-infected Mongolian gerbils associated with a shift in mucin production from glandular to surface mucous cells. Int J Cancer 2006;119:1558-1566.
34.
Toyoda T, Tsukamoto T, Hirano N, Mizoshita T, Kato S, Takasu S, Ban H, Tatematsu M: Synergistic upregulation of inducible nitric oxide synthase and cyclooxygenase-2 in gastric mucosa of Mongolian gerbils by a high-salt diet and Helicobacter pylori infection. Histol Histopathol 2008;23:593-599.
35.
Loh JT, Torres VJ, Cover TL: Regulation of Helicobacter pylori cagA expression in response to salt. Cancer Res 2007;67:4709-4715.
36.
Loh YH, Jakszyn P, Luben RN, Mulligan AA, Mitrou PN, Khaw KT: N-nitroso compounds and cancer incidence: the European Prospective Investigation into Cancer and Nutrition (EPIC)-Norfolk Study. Am J Clin Nutr 2011;93:1053-1061.
37.
Jakszyn P, Bingham S, Pera G, Agudo A, Luben R, Welch A, Boeing H, Del Giudice G, Palli D, Saieva C, Krogh V, Sacerdote C, Tumino R, Panico S, Berglund G, Siman H, Hallmans G, Sanchez MJ, Larranaga N, Barricarte A, Chirlaque MD, Quiros JR, Key TJ, Allen N, Lund E, Carneiro F, Linseisen J, Nagel G, Overvad K, Tjonneland A, Olsen A, Bueno-de-Mesquita HB, Ocke MO, Peeters PH, Numans ME, Clavel-Chapelon F, Trichopoulou A, Fenger C, Stenling R, Ferrari P, Jenab M, Norat T, Riboli E, Gonzalez CA: Endogenous versus exogenous exposure to N-nitroso compounds and gastric cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC-EURGAST) study. Carcinogenesis 2006;27:1497-1501.
38.
Moy KA, Fan Y, Wang R, Gao YT, Yu MC, Yuan JM: Alcohol and tobacco use in relation to gastric cancer: a prospective study of men in Shanghai, China. Cancer Epidemiol Biomarkers Prev 2010;19:2287-2297.
39.
Everatt R, Tamosiunas A, Kuzmickiene I, Virviciute D, Radisauskas R, Reklaitiene R, Milinaviciene E: Alcohol consumption and risk of gastric cancer: a cohort study of men in Kaunas, Lithuania, with up to 30 years follow-up. BMC Cancer 2012;12:475.
40.
Duell EJ, Travier N, Lujan-Barroso L, Clavel-Chapelon F, Boutron-Ruault MC, Morois S, Palli D, Krogh V, Panico S, Tumino R, Sacerdote C, Quiros JR, Sanchez-Cantalejo E, Navarro C, Gurrea AB, Dorronsoro M, Khaw KT, Allen NE, Key TJ, Bueno-de-Mesquita HB, Ros MM, Numans ME, Peeters PH, Trichopoulou A, Naska A, Dilis V, Teucher B, Kaaks R, Boeing H, Schutze M, Regner S, Lindkvist B, Johansson I, Hallmans G, Overvad K, Egeberg R, Tjonneland A, Lund E, Weiderpass E, Braaten T, Romieu I, Ferrari P, Jenab M, Stenling R, Aune D, Norat T, Riboli E, Gonzalez CA: Alcohol consumption and gastric cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Am J Clin Nutr 2011;94:1266-1275.
41.
Proceedings of the IARC Working Group on the Evaluation of Carcinogenic Risks to Humans. Epstein-Barr virus and Kaposi's sarcoma herpesvirus/human herpesvirus 8. Lyon, France, 17-24 June 1997. IARC Monogr Eval Carcinog Risks Hum 1997;70:1-492.
42.
Demetriou CA, Straif K, Vineis P: From testing to estimation: the problem of false positives in the context of carcinogen evaluation in the IARC monographs. Cancer Epidemiol Biomarkers Prev 2012;21:1272-1281.
43.
Camargo MC, Murphy G, Koriyama C, Pfeiffer RM, Kim WH, Herrera-Goepfert R, Corvalan AH, Carrascal E, Abdirad A, Anwar M, Hao Z, Kattoor J, Yoshiwara-Wakabayashi E, Eizuru Y, Rabkin CS, Akiba S: Determinants of Epstein-Barr virus-positive gastric cancer: an international pooled analysis. Br J Cancer 2011;105:38-43.
44.
Wang J, Xu L, Shi R, Huang X, Li SW, Huang Z, Zhang G: Gastric atrophy and intestinal metaplasia before and after Helicobacter pylori eradication: a meta-analysis. Digestion 2011;83:253-260.
45.
Fuccio L, Zagari RM, Eusebi LH, Laterza L, Cennamo V, Ceroni L, Grilli D, Bazzoli F: Meta-analysis: can Helicobacter pylori eradication treatment reduce the risk for gastric cancer? Ann Intern Med 2009;151:121-128.
46.
Ford AC, Forman D, Hunt RH, Yuan Y, Moayyedi P: Helicobacter pylori eradication therapy to prevent gastric cancer in healthy asymptomatic infected individuals: systematic review and meta-analysis of randomised controlled trials. BMJ 2014;348:g3174.
47.
Ma JL, Zhang L, Brown LM, Li JY, Shen L, Pan KF, Liu WD, Hu Y, Han ZX, Crystal-Mansour S, Pee D, Blot WJ, Fraumeni JF Jr, You WC, Gail MH: Fifteen-year effects of Helicobacter pylori, garlic, and vitamin treatments on gastric cancer incidence and mortality. J Natl Cancer Inst 2012;104:488-492.
48.
Fock KM, Katelaris P, Sugano K, Ang TL, Hunt R, Talley NJ, Lam SK, Xiao SD, Tan HJ, Wu CY, Jung HC, Hoang BH, Kachintorn U, Goh KL, Chiba T, Rani AA; Second Asia-Pacific Conference: Second Asia-Pacific Consensus Guidelines for Helicobacter pylori infection. J Gastroenterol Hepatol 2009;24:1587-1600.
49.
Wong BC, Lam SK, Wong WM, Chen JS, Zheng TT, Feng RE, Lai KC, Hu WH, Yuen ST, Leung SY, Fong DY, Ho J, Ching CK: Helicobacter pylori eradication to prevent gastric cancer in a high-risk region of China: a randomized controlled trial. JAMA 2004;291:187-194.
50.
Massarrat S, Haj-Sheykholeslami A, Mohamadkhani A, Zendehdel N, Rakhshani N, Stolte M, Mirzaei M, Saliminejhad M, Saeidi S, Shahidi M: Precancerous conditions after H. pylori eradication: a randomized double blind study in first degree relatives of gastric cancer patients. Arch Iran Med 2012;15:664-669.
51.
Rokkas T, Liatsos C, Petridou E, Papatheodorou G, Karameris A, Ladas SD, Raptis SA: Relationship of Helicobacter pylori CagA(+) status to gastric juice vitamin C levels. Eur J Clin Invest 1999;29:56-62.
52.
Zhang ZW, Patchett SE, Perrett D, Katelaris PH, Domizio P, Farthing MJ: The relation between gastric vitamin C concentrations, mucosal histology, and CagA seropositivity in the human stomach. Gut 1998;43:322-326.
53.
Dai Y, Wang WH: Non-steroidal anti-inflammatory drugs in prevention of gastric cancer. World J Gastroenterol 2006;12:2884-2889.
54.
Sahin IH, Hassan MM, Garrett CR: Impact of non-steroidal anti-inflammatory drugs on gastrointestinal cancers: current state-of-the science. Cancer Lett 2014;345:249-257.
55.
Park B, Shin A, Park SK, Ko KP, Ma SH, Lee EH, Gwack J, Jung EJ, Cho LY, Yang JJ, Yoo KY: Ecological study for refrigerator use, salt, vegetable, and fruit intakes, and gastric cancer. Cancer Causes Control 2011;22:1497-1502.
56.
Bonequi P, Meneses-Gonzalez F, Correa P, Rabkin CS, Camargo MC: Risk factors for gastric cancer in Latin America: a meta-analysis. Cancer Causes Control 2013;24:217-231.
57.
Camargo MC, Kim WH, Chiaravalli AM, Kim KM, Corvalan AH, Matsuo K, Yu J, Sung JJ, Herrera-Goepfert R, Meneses-Gonzalez F, Kijima Y, Natsugoe S, Liao LM, Lissowska J, Kim S, Hu N, Gonzalez CA, Yatabe Y, Koriyama C, Hewitt SM, Akiba S, Gulley ML, Taylor PR, Rabkin CS: Improved survival of gastric cancer with tumour Epstein-Barr virus positivity: an international pooled analysis. Gut 2014;63:236-243.
58.
Qureshi WA, Graham DY: Diagnosis and management of Helicobacter pylori infection. Clin Cornerstone 1999;1:18-28.
59.
You WC, Blot WJ, Li JY, Chang YS, Jin ML, Kneller R, Zhang L, Han ZX, Zeng XR, Liu WD, et al: Precancerous gastric lesions in a population at high risk of stomach cancer. Cancer Res 1993;53:1317-1321.
60.
de Vries AC, van Grieken NC, Looman CW, Casparie MK, de Vries E, Meijer GA, Kuipers EJ: Gastric cancer risk in patients with premalignant gastric lesions: a nationwide cohort study in the Netherlands. Gastroenterology 2008;134:945-952.
61.
Dinis-Ribeiro M, Areia M, de Vries AC, Marcos-Pinto R, Monteiro-Soares M, O'Connor A, Pereira C, Pimentel-Nunes P, Correia R, Ensari A, Dumonceau JM, Machado JC, Macedo G, Malfertheiner P, Matysiak-Budnik T, Megraud F, Miki K, O'Morain C, Peek RM, Ponchon T, Ristimaki A, Rembacken B, Carneiro F, Kuipers EJ: Management of precancerous conditions and lesions in the stomach (MAPS): guideline from the European Society of Gastrointestinal Endoscopy (ESGE), European Helicobacter Study Group (EHSG), European Society of Pathology (ESP), and the Sociedade Portuguesa de Endoscopia Digestiva (SPED). Endoscopy 2012;44:74-94.
62.
Neumann H, Fujishiro M, Wilcox CM, Monkemuller K: Present and future perspectives of virtual chromoendoscopy with i-scan and optical enhancement technology. Dig Endosc 2014;26(suppl 1):43-51.
63.
Pirogov SS, Sokolov VV, Karpova ES, Pavlov PV, Volchenko NN, Kaprin AD: Early gastric cancer and precancerous conditions diagnostics with confocal laser endomicroscopy (in Russian). Eksp Klin Gastroenterol 2014;3:18-24.
64.
Kawai T, Yanagizawa K, Naito S, Sugimoto H, Fukuzawa M, Gotoda T, Matsubayashi J, Nagao T, Hoshino S, Tsuchida A, Moriyasu F: Evaluation of gastric cancer diagnosis using new ultrathin transnasal endoscopy with narrow-band imaging: preliminary study. J Gastroenterol Hepatol 2014;29(suppl 4):33-36.
65.
Kawamura M, Sekine H, Abe S, Shibuya D, Kato K, Masuda T: Clinical significance of white gastric crypt openings observed via magnifying endoscopy. World J Gastroenterol 2013;19:9392-9398.
66.
Boeriu A, Boeriu C, Drasovean S, Pascarenco O, Mocan S, Stoian M, Dobru D: Narrow-band imaging with magnifying endoscopy for the evaluation of gastrointestinal lesions. World J Gastrointest Endosc 2015;7:110-120.
67.
Qumseya BJ, Wang H, Badie N, Uzomba RN, Parasa S, White DL, Wolfsen H, Sharma P, Wallace MB: Advanced imaging technologies increase detection of dysplasia and neoplasia in patients with Barrett's esophagus: a meta-analysis and systematic review. Clin Gastroenterol Hepatol 2013;11:1562-1570.e1-2.
68.
Yu H, Yang AM, Lu XH, Zhou WX, Yao F, Fei GJ, Guo T, Yao LQ, He LP, Wang BM: Magnifying narrow-band imaging endoscopy is superior in diagnosis of early gastric cancer. World J Gastroenterol 2015;21:9156-9162.
69.
Zhang Q, Wang F, Chen ZY, Wang Z, Zhi FC, Liu S, Bai Y: Comparison of the diagnostic efficacy of white light endoscopy and magnifying endoscopy with narrow band imaging for early gastric cancer: a meta-analysis. Gastric Cancer 2015, Epub ahead of print.
70.
Bretthauer M, Kalager M, Adami HO: Do's and don'ts in evaluation of endoscopic screening for gastrointestinal cancers. Endoscopy 2016;48:75-80.
71.
Storskrubb T, Aro P, Ronkainen J, Sipponen P, Nyhlin H, Talley NJ, Engstrand L, Stolte M, Vieth M, Walker M, Agreus L: Serum biomarkers provide an accurate method for diagnosis of atrophic gastritis in a general population: The Kalixanda study. Scand J Gastroenterol 2008;43:1448-1455.
72.
Ren JS, Kamangar F, Qiao YL, Taylor PR, Liang H, Dawsey SM, Liu B, Fan JH, Abnet CC: Serum pepsinogens and risk of gastric and oesophageal cancers in the General Population Nutrition Intervention Trial cohort. Gut 2009;58:636-642.
73.
Zoalfaghari A, Aletaha N, Roushan N, Taslimi R, Foroutan H, Faridnia B: Accuracy of pepsinogens for early diagnosis of atrophic gastritis and gastric cancer in Iranian population. Med J Islam Repub Iran 2014;28:150.
74.
Hattori Y, Tashiro H, Kawamoto T, Kodama Y: Sensitivity and specificity of mass screening for gastric cancer using the measurement of serum pepsinogens. Jpn J Cancer Res 1995;86:1210-1215.
75.
Watabe H, Mitsushima T, Yamaji Y, Okamoto M, Wada R, Kokubo T, Doi H, Yoshida H, Kawabe T, Omata M: Predicting the development of gastric cancer from combining Helicobacter pylori antibodies and serum pepsinogen status: a prospective endoscopic cohort study. Gut 2005;54:764-768.
76.
Murphy G, Kamangar F, Dawsey SM, Stanczyk FZ, Weinstein SJ, Taylor PR, Virtamo J, Abnet CC, Albanes D, Freedman ND: The relationship between serum ghrelin and the risk of gastric and esophagogastric junctional adenocarcinomas. J Natl Cancer Inst 2011;103:1123-1129.
77.
Sadjadi A, Yazdanbod A, Lee YY, Boreiri M, Samadi F, Alizadeh BZ, Islami F, Fyfe V, Babaei M, Namazi MJ, Going JJ, Sotoudeh M, de Bock GH, Malekzadeh R, Derakhshan MH: Serum ghrelin; a new surrogate marker of gastric mucosal alterations in upper gastrointestinal carcinogenesis. PLoS One 2013;8:e74440.
78.
Agreus L, Kuipers EJ, Kupcinskas L, Malfertheiner P, Di Mario F, Leja M, Mahachai V, Yaron N, van Oijen M, Perez Perez G, Rugge M, Ronkainen J, Salaspuro M, Sipponen P, Sugano K, Sung J: Rationale in diagnosis and screening of atrophic gastritis with stomach-specific plasma biomarkers. Scand J Gastroenterol 2012;47:136-147.
79.
Leja M, Kupcinskas L, Funka K, Sudraba A, Jonaitis L, Ivanauskas A, Janciauskas D, Kuidelis G, Chiu HM, Lin JT: Value of gastrin-17 in detecting antral atrophy. Adv Med Sci 2011;56:145-150.
80.
Aikou S, Ohmoto Y, Gunji T, Matsuhashi N, Ohtsu H, Miura H, Kubota K, Yamagata Y, Seto Y, Nakajima A, Goldenring JR, Kaminishi M, Nomura S: Tests for serum levels of trefoil factor family proteins can improve gastric cancer screening. Gastroenterology 2011;141:837-845.e1-7.
81.
Huang Z, Zhang X, Lu H, Wu L, Wang D, Zhang Q, Ding H: Serum trefoil factor 3 is a promising non-invasive biomarker for gastric cancer screening: a monocentric cohort study in China. BMC Gastroenterol 2014;14:74.
82.
Zhang Y, Weck MN, Schottker B, Rothenbacher D, Brenner H: Gastric parietal cell antibodies, Helicobacter pylori infection, and chronic atrophic gastritis: evidence from a large population-based study in Germany. Cancer Epidemiol Biomarkers Prev 2013;22:821-826.
83.
Bray F, Ren JS, Masuyer E, Ferlay J: Global estimates of cancer prevalence for 27 sites in the adult population in 2008. Int J Cancer 2013;132:1133-1145.
84.
Siegel R, Ma J, Zou Z, Jemal A: Cancer statistics, 2014. CA Cancer J Clin 2014;64:9-29.
© 2016 S. Karger AG, Basel
2016
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.
