Gastric Mucosal Molecular Alterations and Multimodal Field-Based Risk Models for Gastric Cancer Development.

Area of Science:

• Gastroenterology and Oncology
• Molecular Biology
• Biomarker Discovery

Background:

• Gastric cancer risk is multifactorial, including H. pylori infection, lifestyle, and precancerous changes like atrophy and intestinal metaplasia.
• Current risk stratification using clinical, endoscopic, and histological data shows outcome heterogeneity.
• The concept of a gastric "multimodal field" offers a new layer for risk assessment.

Purpose of the Study:

• To review evidence for the gastric "multimodal field" concept in risk assessment.
• To emphasize DNA methylation as a biomarker for field cancerization.
• To support an integrated approach for personalized gastric cancer surveillance.

Main Methods:

• Review of prospective studies and deep profiling of high-risk intestinal metaplasia.
• Analysis of DNA methylation patterns associated with inflammation and exposures.
• Integration of methylation markers with clinical variables in a longitudinal cohort.

Main Results:

• Evidence supports methylation-based field cancerization, particularly in high-risk intestinal metaplasia.
• A longitudinal study demonstrated the utility of combining methylation markers with clinical data.
• DNA methylation serves as a scalable biomarker for assessing the gastric multimodal field.

Conclusions:

• The gastric "multimodal field" concept, assessed via DNA methylation, enhances risk stratification.
• Integrating methylation markers with clinical variables improves predictive precision.
• This multimodal approach supports more effective personalized surveillance strategies for gastric cancer.