Gastric cancer research in Mexico: A public health priority

Table 1 Epidemiological studies of gastric cancer in Mexico

Ref.	Year	Institute of adscription of corresponding author-city	Period of study	Main finding	Source
[23]	2013	IMSSMexico City	NA	There is no association between altitude and the incidence and mortality of gastric cancer	Epidemiological observations
[20]	2012	UVVeracruz, Veracruz	2005-2009	From a total of 1803 cases of digestive tract cancers, gastric cancer was the second most common, with 302 cases (16.76%)	Hospital registries from 5 institutions of Veracruz state
[22]	2012	INCanMexico City	1993-2002	From a total of 767464 cases of digestive system cancers, gastric cancer was the sixth most common with 27659 cases (4%): the third most common in males and seventh in females	Data-base of the histopathological register of malignant neoplasms in Mexico (RHNM)
[21]	2003	INCMNSZMexico City	1978-2001	A total of 90% of the cases were diagnosed in people of age 41 years and moreFrom a total of 11276 cases of digestive system cancers, 3830 (34%) were of gastric cancer	Hospital registries from 6 institutions of Mexico City
[5]	2001	INSPCuernavaca, Morelos	1980-1997	Increase in adjusted mortality rateGender-based differential trend in the magnitude and prematurity of mortality	INEGI

H. pylori: Helicobacter pylori; NA: Non applicable; IMSS: Mexican Institute of Social Security/Instituto Mexicano del Seguro Social; UV: University of Veracruz/Universidad Veracruzana; INCan: National Institute of Cancerology/Instituto Nacional de Cancerología; RHNM: Histopathological Register of Malignant Neoplasms/Registro Histopatológico de Neoplasias Malignas; INCMNSZ: National Institute of Medical Science and Nutrition Salvador Zubiran/Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán; INSP: National Institute of Public Health/Instituto Nacional de Salud Pública; INEGI: National Institute of Statistics and Geography/Instituto Nacional de Estadística y Geografía.

Table 2 Studies of risk and protection factors in gastric cancer in the Mexican population

Ref.	Year	Institute of adscription of corresponding author-city	Main finding	Quantity and type of groups studied
[25]	2012	UVXalapa, Veracruz	Protective effect against gastric cancer: use of mouthwash, refrigeration of food and regular consumption of fruit and vegetablesRisk of gastric cancer: omission of breakfast and failure to refrigerate food	49 gastric cancer162 controls
[27]	2012	INSPCuernavaca, Morelos	Risk of gastric cancer: moderate to high capsaicin consumption synergistically in genetically susceptible individuals (IL-1B-31C allele carriers) infected with more virulent H. pylori (CagA positive) strains	158 gastric cancer317 controls
[28]	2009	INSPCuernavaca, Morelos	Protective effect against gastric cancer: higher intake of cinnamic acids, secoisolariciresinol and coumestrol.Main sources of these molecules: pears, mangos, beans, carrots, squash and legumes	257 gastric cancer478 controls
[29]	2003	INSPCuernavaca, Morelos	Risk of gastric cancer: high consumption of capsaicin (90-250 mg of capsaicin per day, 9-25 jalapeno peppers per day), compared to low-level consumption (0-29.9 mg of capsaicin per day, 0-3 jalapeno peppers per day); this effect is independent of H. pylori status	234 gastric cancer468 controls
[30]	1999	INSPCuernavaca, Morelos	Protective effect against gastric cancer: intake of polyunsaturated fat, fiber and vitamin E, independent of the histological type of the tumor (intestinal or diffuse)Risk of gastric cancer: consumption of saturated fat and cholesterol	220 gastric cancer752 controls
[26]	1999	NCI1Bethesda, MD, United States	Protective effect against gastric cancer: intake of yellow and orange vegetables.Risk of gastric cancer: consumption of fresh and processed meat, dairy products, fish and salty snacks	220 gastric cancer752 controls
[31]	1998	INSPCuernavaca, Morelos	No association with risk of gastric cancer: consumption of foods prepared with corn, wheat or rice	220 gastric cancer752 controls
[32]	1998	INSPCuernavaca, Morelos	Risk of gastric cancer: wine consumption at least 10 glasses per month.No association with risk for gastric cancer: consumption of beer and distilled alcoholic beverages including brandy, rum and tequila	220 gastric cancer752 controls
[33]	1994	INSPCuernavaca, Morelos	Potential risk of gastric cancer: chili pepper consumption	220 gastric cancer 752 controls

¹In collaboration with the INSP. H. pylori: Helicobacter pylori; UV: University of Veracruz/Universidad Veracruzana; INSP: National Institute of Public Health/Instituto Nacional de Salud Pública; NCI: National Cancer Institute.

Table 3 Studies of Helicobacter pylori in pathologies associated with the development of gastric cancer and gastric cancer in a Mexican population

Ref.	Year	Institute of adscription of corresponding author-city	Main finding	Quantity and type of groups studied
[39]	2013	ISSSTECuliacan, Sinaloa	Association between alcohol consumption and H. pylori infection.No relationship between H. pylori and smoking and coffee consumption	269 H. pylori positive 269 H. pylori negative
[46]	2013	IMSSMexico City	Association between H. pylori and p53 expression and between p53 and intestinal metaplasia	104 patients with no evidence of acute or clinically significant gastric pathology
[41]	2013	INSPCuernavaca, Morelos	IgG2 response to CagA could be used as a novel serological marker to identify patients with H. pylori-associated gastric cancer	46 intestinal metaplasia41 gastric cancer50 controls
[47]	2013	INSPCuernavaca, Morelos	No association between CagA and gastric cancer	67 gastric cancer 368 non atrophic gastritis124 preneoplastic lesion
[48]	2012	UNAMMexico City	Correlation of antibody subclass titers with Th1/Th2 markers may aid pathology characterization and diagnosis	14 gastric cancer5 peptic ulcer13 bleeding peptic ulcer12 dyspepsia
[49]	2012	IMSSMexico City	Failure to express cag19 and cag24 in vivo in precancerous lesions might serve as a biomarker of the risk of development of gastric cancer	11 gastric cancer10 non atrophic gastritis10 duodenal ulcer
[40]	2011	INSPCuernavaca, Morelos	Vac-A neutralizing antibodies might serve as a biomarker of the risk of development of gastric cancer and duodenal ulcer	90 intestinal metaplasia60 gastric cancer52 duodenal ulcer145 non atrophic gastritis
[43]	2009	UNAMTlalnepantla, Estado de Mexico	Patients with chronic gastritis had a high incidence of infection by H. pylori; 44% of the H. pylori strains may be considered as highly virulent since they possessed two or three of the virulence markers analyzed: vacA s1 cagA babA2	238 chronic gastritis
[50]	2009	IMSSMexico City	30 genes are significantly associated with non-atrophic gastritis, duodenal ulcer, or gastric cancer and may serve as risk biomarkers	10 non atrophic gastritis10 duodenal ulcer9 gastric cancer
[51]	2008	UNAMMexico City	H. pylori is uniformly distributed across the stomach in dyspepsia and has preference for fundus and corpus in gastric cancer.H. pylori genotype diversity across the systematic whole-organ and tumor is remarkable.There is insufficient evidence to support the association of one isolate with a specific disease, due to the multistrain nature of H. pylori	16 gastric cancer14 dyspepsia
[38]	2008	INSPCuernavaca, Morelos	H. pylori infection and CagA are risk markers for intestinal metaplasia. In gastric cancer, prevalence of these risk markers decreases, probably reflecting the fact that infection reduces when advanced atrophy and metaplasia develops	368 non atrophic gastritis126 precancerous lesions65 gastric cancer59 duodenal ulcer
[52]	2004	UANLNuevo Leon, Nuevo Leon	Absence of the HLA-DQA1*0503 allele could be a host risk factor for the development of gastric cancer.Infection with H. pylori CagA+, VacA+ strains represents a significant risk in terms of the development of gastric cancer	22 gastric cancer H. pylori positive8 high grade dysplasia H. pylori positive77 matched controls H. pylori positive
[37]	2004	INSPCuernavaca, Morelos	There is no association between nitrite and ascorbic consumption or interactions of these nutrients with seropositivity to H. pylori CagA+.Seropositivity to H. pylori CagA+ strains may be an independent factor in diffuse gastric cancer	211 gastric cancer454 controls
[53]	2001	SU1California, United States	In regions with a high prevalence of chronic atrophic gastritis, serological screening with CagA alone is an effective test for identifying eligible subjects	178 H. pylori positive155 H. pylori CagA+
[45]	1997	INSPCuernavaca, Morelos	H. pylori infection present in 87.2% of cases and 82.5% of controls	109 gastric cancer 177 controls
[44]	1993	INCanMexico City	In a high-risk population, precursor lesions for adenocarcinoma are universally associated with H. pylori infection	245 symptomatic patients

¹In collaboration with INCan, UNAM Mexico City and the Colegio de la Frontera Sur, San Cristobal de las Casas, Chiapas. H. pylori: Helicobacter pylori; ISSSTE: Institute of Social Security and Services of State Employees/Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado; IMSS: Mexican Institute of Social Security/Instituto Mexicano del Seguro Social; INSP: National Institute of Public Health/Instituto Nacional de Salud Pública; EBV: Epstein-Barr virus; UNAM: National Autonomous University of Mexico/Universidad Nacional Autónoma de México; UANL: Autonomous University of Nuevo Leon/Universidad Autónoma de Nuevo León; SU: Stanford University; INCan: National Institute of Cancerology/Instituto Nacional de Cancerología.

Table 4 Studies of the Epstein-Barr virus in pathologies associated with the development of gastric cancer and gastric cancer in a Mexican population

Ref.	Year	Institute of adscription of corresponding author-city	Main finding	Quantity and type of groups studied
[54]	2013	IMSSMexico City	Co-infection with EBV and H. pylori in pediatric patients is associated with severe gastritis	333 pediatric patients with chronic abdominal pain
[56]	2005	INCanMexico City	EBV was detected in 7.3% of cases, all pertaining to patients > 50 years of age.Among Latin-American countries, Mexico has the lowest frequency of EBV associated gastric carcinoma	330 gastric cancer
[55]	1999	INCanMexico City	EBV is detected in 8.15% cases, six occur in males and five in females	135 gastric cancer

H. pylori: Helicobacter pylori; IMSS: Mexican Institute of Social Security/Instituto Mexicano del Seguro Social; INCan: National Institute of Cancerology/Instituto Nacional de Cancerología; EBV: Epstein-Barr virus.

Table 5 Studies of molecular markers for the development of gastric cancer and gastric cancer in a Mexican population

Ref.	Year	Institute of adscription of corresponding author-city	Main finding	Quantity and type of groups studied
[67]	2013	UG Guadalajara, Jalisco	EGFR-R521K and ERBB2-1655V polymorphisms are not suitable as markers for identifying individuals at risk of developing gastric cancer	155 gastric cancer 121 controls 103 general population
[62]	2013	INCMSZ Mexico City	HER2 amplification is restricted to intestinal gastric cancer. HER2 amplification is suitable as a marker for screening gastric cancer histotype	269 gastric cancer
[59]	2010	UV Xalapa, Veracruz	MMP9 expression is enhanced in gastric cancer compared to normal mucosa, and has potential as a molecular marker	6 gastric cancer 11 superficial gastritis
[68]	2010	UNAM Mexico City	Claudin 6, 7, and 9 expression is related to gastric carcinogenesis, and detection of these is a useful prognostic marker in intestinal and diffuse gastric cancer	70 gastric cancer
[60]	2010	IMSS Mexico City	Polymorphisms in TNF and HSP70 have a severity dose-response as risk markers from preneoplastic lesions to gastric cancer, probably because of their association with an intense and sustained inflammatory response	228 non atrophic gastritis 98 intestinal metaplasia 63 gastric cancer 58 duodenal ulcer 132 controls
[63]	2009	INSP Cuernavaca, Morelos	In subjects with high consumption of folate, choline and vitamin B6, and 5,10-methylenetetrahydrofolate reductase (MTHFR) 677 TT genotype, there is a reduction in diffuse gastric risk compared to MTHFR 677 CC + CT carriers. In subjects with low consumption of methionine and MTHFR 677 TT genotype, there is a reduced risk of diffuse gastric cancer compared to MTHFR 677 CC + CT carriers. Carriers of the MTHFR 677 TT genotype with a low consumption of folate have a significantly increased risk of development of intestinal gastric cancer	248 gastric cancer 478 controls
[69]	2007	UANL Monterrey, Nuevo Leon	There is no association between the MTHFR C677T polymorphism and development of gastric cancer	51 gastric cancer 83 controls
[57]	2007	INCMSZ Mexico City	The -160 C/A polymorphism of E-cadherin has a direct effect on the risk of diffuse gastric cancer at a young age	39 gastric cancer younger than 45 years of age 78 controls
[61]	2007	UANL Monterrey, Nuevo Leon	The IL-8-251*A allele could be related to the development of gastric cancer	78 gastric cancer 259 controls
[70]	2006	INSP Cuernavaca, Morelos	High prevalence of MTHFR 677T allele may be a contributor to the high rate of morbidity and mortality in gastric cancer	201 gastric cancer 427 controls
[71]	2006	LSU1 New Orleans, United States	Identification of the IL-1B-31 promoter polymorphism is a useful marker for the risk of intestinal type gastric cancer in subjects with CagA+H. pylori infection	183 gastric cancer 377 controls
[58]	2005	NYU2 New York, United States	Carrying the Arg/Arg genotype in the codon 72 exon 4 of p53 is associated with risk of development of gastric cancer	65 gastric cancer 182 controls
[72]	2005	UANL Monterrey, Nuevo Leon	Carrying the proinflammatory IL-1B-31*C allele is associated with increased risk of gastric cancer	63 gastric cancer 215 controls
[73]	2004	INCan Mexico City	There is an association of major histocompatibility complex HLA-DQA1*0601 and HLA-DQB1*0501 alleles in gastric cancer compared to chronic gastritis and the healthy condition. These HLA-DQ alleles may be conferring susceptibility for the development of gastric cancer	20 gastric cancer 40 H. pylori-associated chronic gastritis 90 controls
[74]	2003	UANL Monterrey, Nuevo Leon	Carrying the pro-inflammatory IL-1B-31*C allele is associated with an increased risk of gastric cancer and high-grade dysplasia	33 gastric cancer 8 high-grade dysplasia 25 controls

¹In collaboration with INSP; 2In collaboration with UANL. H. pylori: Helicobacter pylori; UG: University of Guadalajara/Universidad de Guadalajara; INCMNSZ: National Institute of Medical Science and Nutrition Salvador Zubiran/Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán; UV: University of Veracruz/Universidad Veracruzana; UNAM: National Autonomous University of Mexico/Universidad Nacional Autónoma de México; IMSS: Mexican Institute of Social Security/Instituto Mexicano del Seguro Social; INSP: National Institute of Public Health/Instituto Nacional de Salud Pública; UANL: Autonomous University of Nuevo leon/Universidad Autónoma de Nuevo León; LSU: Louisiana State University; NYU: New York University; INCan: National Institute of Cancerology/Instituto Nacional de Cancerología.