Epigenetic Alterations in the Gastrointestinal Tract: Current and Emerging Use for Biomarkers of Cancer

Gastroenterology. 2021 Feb;160(3):690-709. doi: 10.1053/j.gastro.2020.09.058. Epub 2020 Dec 3.

Abstract

Colorectal cancer, liver cancer, stomach cancer, pancreatic cancer, and esophageal cancer are leading causes of cancer-related deaths worldwide. A fundamental trait of virtually all gastrointestinal cancers is genomic and epigenomic DNA alterations. Cancer cells acquire genetic and epigenetic alterations that drive the initiation and progression of the cancers by altering the molecular and cell biological processes of the cells. These alterations, as well as other host and microenvironment factors, ultimately mediate the clinical behavior of the precancers and cancers and can be used as biomarkers for cancer risk determination, early detection of cancer and precancer, determination of the prognosis of cancer and prediction of the response to therapy. Epigenetic alterations have emerged as one of most robust classes of biomarkers and are the basis for a growing number of clinical tests for cancer screening and surveillance.

Keywords: Barrett’s Esophagus; Biomarkers; Chromatin; Colorectal Cancer; DNA; Diagnosis; Esophageal Cancer; Gastric Cancer; Histone; Methylation; Noncoding RNA; Pancreatic Cancer; Predictive; Prognosis; Treatment.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Biomarkers, Tumor / analysis
  • Biomarkers, Tumor / genetics*
  • Chromatin / genetics
  • Chromatin / metabolism
  • DNA Methylation
  • Disease Progression
  • Early Detection of Cancer / methods
  • Epigenesis, Genetic*
  • Epigenomics / methods
  • Gastrointestinal Neoplasms / diagnosis
  • Gastrointestinal Neoplasms / epidemiology
  • Gastrointestinal Neoplasms / genetics*
  • Gastrointestinal Neoplasms / pathology
  • Gastrointestinal Tract / pathology
  • Gene Expression Regulation, Neoplastic*
  • Histones / genetics
  • Histones / metabolism
  • Humans
  • Risk Assessment / methods
  • Tumor Microenvironment / genetics

Substances

  • Biomarkers, Tumor
  • Chromatin
  • Histones