Serum markers and gastric cancer: an umbrella review

Early detection of gastric cancer (GC) is crucial for lowering the mortality risk and health burden. Since various biomarkers have been studied for the early diagnosis of GC, this umbrella focuses on the serum markers valuable in GC, for whether detecting or predicting the risk.

Following the PRISMA statement and Joanna Briggs Institute (JBI) Manual, PubMed, Scopus, and Web of Science were searched before August 31, 2023. English-language systematic reviews that assessed the association between serum markers and the presence of and/or predicting the risk of GC with or without meta-analyses were included in this umbrella review. The chosen reviews assessed serum markers in GC, and the quality assessment was conducted by the JBI critical appraisal tool for systematic reviews.

From 1441 records that remained after removing the duplicates, only seven were selected. The investigated serum markers in the studies included SOD activity, selenium, adiponectin dickkopf-1, pepsinogens, and autoantibodies. The bias risk in most of the included reviews was appropriately low. Overall, the SOD activity, circulating adiponectin, and selenium are suggested to be lower in patients with GC. Serum dickkopf-1 and serum pepsinogen are also proposed as potential biomarkers for GC. Considering the great heterogeneity between the studies, the possibility of publication bias, and the limited number of the included studies further investigation is required.

The explained serum biomarkers could be helpful for diagnosis and predicting GC; however, further well-designed large-scale investigation is needed to ensure their clinical applications.