Cancer Genetics and Epigenetics 2024, Vol.12, No.3, 115-124 http://medscipublisher.com/index.php/cge 115 Systematic Review Open Access A Review of Genetic and Epigenetic Regulation in Gastric Cancer Wei Zhang Zhejiang Cancer Hospital, Hangzhou, 310022, Zhejiang, China Corresponding email: weizhang@qq.com Cancer Genetics and Epigenetics, 2024, Vol.12, No.3 doi: 10.5376/cge.2024.12.0014 Received: 13 Mar., 2024 Accepted: 22 Apr., 2024 Published: 05 May, 2024 Copyright © 2024 Zhang, This is an open access article published under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Preferred citation for this article: Zhang W., 2024, A review of genetic and epigenetic regulation in gastric cancer, Cancer Genetics and Epigenetics, 12(3): 115-124 (10.5376/cge.2024.12.0014) Abstract Gastric cancer a leading cause of cancer-related deaths worldwide, necessitating a comprehensive understanding of its underlying mechanisms. This study explores the genetic and epigenetic regulation in gastric cancer, highlighting the critical roles of oncogenes, tumor suppressor genes, and chromosomal aberrations. Genome-wide association studies (GWAS) are discussed for their contributions to identifying genetic predispositions. Additionally, the study delves into epigenetic mechanisms, including DNA methylation, histone modifications, and non-coding RNAs, and their impact on gene expression. The interplay between genetic and epigenetic changes is examined, emphasizing the interaction effects and the benefits of integrated genomic and epigenomic approaches. Clinical implications are addressed, focusing on diagnostic and prognostic biomarkers, therapeutic targets, and the potential for personalized medicine. The study also considers the challenges and limitations in studying gastric cancer, such as its complexity, technical constraints, and biological variability. Future directions point to the promise of emerging technologies, integrative and multi-omics approaches, and global epidemiological studies in advancing the understanding and treatment of gastric cancer. The study concludes by summarizing key findings and underscoring the importance of ongoing research in this field. Keywords Gastric cancer; Genetic regulation; Epigenetic mechanisms; Biomarkers; Personalized medicine 1 Introduction Gastric cancer (GC) is one of the most prevalent and deadly malignancies worldwide, ranking as the fourth most common cancer and the third leading cause of cancer-related deaths globally (Ebrahimi et al., 2020). The incidence of GC is particularly high in developing countries, where over 70% of new cases and deaths occur (Qu et al., 2013). Despite advancements in diagnosis and treatment, the prognosis for GC remains poor, largely due to late-stage diagnosis and the complex, heterogeneous nature of the disease (Puneet et al., 2018). The pathogenesis of gastric cancer involves a multifaceted interplay between genetic mutations and epigenetic alterations. Genetic mutations, such as those in the TP53, CDH1, and KRAS genes, have long been recognized as critical drivers of GC (Yoda et al., 2015). However, recent research has highlighted the significant role of epigenetic mechanisms, including DNA methylation, histone modifications, and non-coding RNAs, in the regulation of gene expression and tumor progression (Nemtsova et al., 2021; Capparelli and Iannelli, 2022). Epigenetic changes are heritable yet reversible, making them attractive targets for therapeutic intervention (Puneet et al., 2018; Ebrahimi et al., 2020). For instance, aberrant DNA methylation in the promoter regions of tumor suppressor genes can lead to their inactivation, contributing to oncogenesis (Qu et al., 2013). Similarly, histone modifications and chromatin remodeling can alter the expression of genes involved in cell cycle regulation, apoptosis, and metastasis (Kang et al., 2014; Kang et al., 2017). This study aims to provide a comprehensive overview of the current understanding of genetic and epigenetic regulation in gastric cancer. By synthesizing findings from recent studies, we seek to elucidate the molecular mechanisms underlying GC pathogenesis and progression. The study will cover key genetic mutations and epigenetic alterations, their clinical implications, and potential therapeutic strategies targeting these molecular changes. Through this analysis, we hope to identify gaps in the current knowledge and suggest directions for future research, ultimately contributing to the development of more effective diagnostic and therapeutic approaches for gastric cancer. Understanding the genetic and epigenetic landscape of gastric cancer is crucial for improving patient outcomes. This study will explore the intricate regulatory networks that drive GC,
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