Published online Aug 7, 2016. doi: 10.3748/wjg.v22.i29.6619
Peer-review started: March 28, 2016
First decision: May 30, 2016
Revised: June 12, 2016
Accepted: July 6, 2016
Article in press: July 6, 2016
Published online: August 7, 2016
Processing time: 123 Days and 19.9 Hours
Gastric cancer (GC) is the fifth most common malignancy in the world. The major cause of GC is chronic infection with Helicobacter pylori (H. pylori). Infection with H. pylori leads to an active inflammatory microenvironment that is maintained by immune cells such as T cells, macrophages, natural killer cells, among other cells. Immune cell dysfunction allows the initiation and accumulation of mutations in GC cells, inducing aberrant proliferation and protection from apoptosis. Meanwhile, immune cells can secrete certain signals, including cytokines, and chemokines, to alter intracellular signaling pathways in GC cells. Thus, GC cells obtain the ability to metastasize to lymph nodes by undergoing the epithelial-mesenchymal transition (EMT), whereby epithelial cells lose their epithelial attributes and acquire a mesenchymal cell phenotype. Metastasis is a leading cause of death for GC patients, and the involved mechanisms are still under investigation. In this review, we summarize the current research on how the inflammatory environment affects GC initiation and metastasis via EMT.
Core tip: The major cause of gastric cancer (GC) is Helicobacter pylori infection, resulting in an inflammatory microenvironment in GC. Meanwhile, the leading cause of death for GC patients is metastasis. The major pathway for metastasis is the epithelial-mesenchymal transition (EMT). Therefore, a thorough understanding of how the inflammatory microenvironment contributes to the promotion of the EMT is indispensable for developing new treatments. In this review, we summarize the mechanisms of inflammatory mediators, divided among immune cells and molecules, on the prognosis of GC patients and EMT, which suggests that a combination of immunotherapy and anti-EMT treatments may be encouraging for the treatment of GC.