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Although the Correa cascade is widely used as a model for gastric carcinogenesis, the molecular mechanisms driving the transition from chronic atrophic gastritis to invasive cancer have not been comprehensively integrated. This review synthesizes molecular events across Correa stages and evaluates biomarkers for risk stratification, early diagnosis, and personalized surveillance. It links inflammation-driven epigenetic and genetic alterations to clonal selection, malignancy, and tumor microenvironment remodeling.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/molecular-mechanisms-and-biomarkers-driving-the-transition-from-chronic-atrophic-gastritis-to-gastric-cancer/357764/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/molecular-mechanisms-and-biomarkers-driving-the-transition-from-chronic-atrophic-gastritis-to-gastric-cancer/357764.png","ImageObject",300,407,{"name":92,"@type":93},"kopisore","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-23",true,{"@type":102,"interactionType":103,"userInteractionCount":44},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What model is used to describe gastric carcinogenesis in the review?","Question",{"text":112,"@type":113},"The review uses the Correa cascade, which outlines progression from chronic inflammation to atrophic gastritis, intestinal metaplasia, dysplasia, and ultimately invasive carcinoma.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"Which molecular processes are emphasized for the transition toward gastric cancer?",{"text":117,"@type":113},"Key processes include inflammatory cytokine networks, epigenetic modifications, genomic instability, disruption of signaling pathways, clonal evolution, and remodeling of the tumor microenvironment.",{"name":119,"@type":110,"acceptedAnswer":120},"How are biomarkers intended to improve clinical management?",{"text":121,"@type":113},"By integrating molecular biomarkers with conventional morphological assessment, the review suggests improved risk stratification, earlier detection of progression, and support for personalized prevention, surveillance, and treatment strategies.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},357764,1790441465,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":44,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":56,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144},962090880963,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","Molecular Mechanisms and Biomarkers Driving the Transition From Chronic Atrophic Gastritis to Gastric Cancer  \nClinical Medicine Insights: Oncology  \nVolume 20: 1–19 © The Author(s) 2026 Article reuse guidelines:  \n[sagepub.com/journals-permissions](sagepub.com/journals-permissions)  \n[DOI: 10.1177/11795549261478177](DOI: 10.1177/11795549261478177)  \n[journals.sagepub.com/home/onc](journals.sagepub.com/home/onc)  \nYerlan Suleimenov1 , Ainur Samigatova2 , Bakhytzhan Seksenbayev3 , Nursulu Altaeva4 , Ayazhan Zhorayeva3 , Aruzhan Bakytzhan4 , and Assylkhan Bekbayev3   \nAbstract  \nGastric cancer continues to be a major contributor to global cancer morbidity and mortality. Although the Correa cascade is widely used as a model for gastric carcinogenesis, the molecular mechanisms driving the transition from chronic atrophic gastritis to invasive cancer have not been comprehensively integrated into a unified molecular framework. This review aims to synthesize current knowledge of the molecular events associated with each stage of the Correa cascade and to evaluate the clinical relevance of established and emerging biomarkers for risk stratification, early diagnosis, and personalized surveillance.  \nThis review summarizes the principal molecular mechanisms involved in the progression from chronic gastritis through chronic atrophic gastritis, intestinal metaplasia, dysplasia, and ultimately gastric cancer. These mechanisms include inflammatory cytokine networks, epigenetic modifications, genomic instability, disruption of signaling pathways, clonal evolution, and remodeling of the tumor microenvironment. Particular emphasis is placed on contemporary tissue and circulating biomarkers, their diagnostic and prognostic significance, and the application of advanced technologies including multi-omics analysis, spatial transcriptomics, single-cell sequencing, and liquid biopsy.  \nThe available evidence supports a conceptual model of gastric carcinogenesis as a continuous molecular evolutionary process in which chronic inflammation initiates progressive epigenetic and genetic alterations that promote clonal selection and malignant transformation. Integrating molecular biomarkers with conventional morphological assessment may improve risk stratification, facilitate earlier detection of disease progression, and support the implementation of personalized strategies for gastric cancer prevention, surveillance, and treatment.  \nKeywords  \ngastritis, atrophic, stomach neoplasms, Helicobacter pylori, intestinal metaplasia, epigenesis, genetic, genomic instability, biomarkers, tumor, DNA methylation  \nReceived: 9 May 2026; Revised: 19 July 2026; Accepted: 31 July 2026  \n1CDL OLYMP LLP, QazGene LLP, Astana, Kazakhstan 2QazGene LLP, Astana Medical University, Astana, Kazakhstan 3CDL OLYMP LLP, Astana, Kazakhstan  \n4Department of Medical Genetics and Molecular Biology, Astana Medical University, Astana, Kazakhstan  \nCorresponding author:  \nAinur Samigatova, QazGene LLP, Astana Medical University, Beibitshilik Street 49/A, Astana 010000, Kazakhstan.  \nEmail: [ainur.samigatova86@gmail.com](ainur.samigatova86@gmail.com)  \nCreative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons  \nAttribution-NonCommercial 4.0 License ([https://creativecommons.org/licenses/by-nc/4.0/](https://creativecommons.org/licenses/by-nc/4.0/)) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ([https://us.sagepub.com/en-us/nam/open-access-at-sage](https://us.sagepub.com/en-us/nam/open-access-at-sage)).  \n1. Introduction  \nGastric cancer (GC) remains a major global health concern, consistently ranking among the leading causes of cancer incidence and mortality worldwide. According to the Global Cancer Observatory (GLOBOCAN, 2022), over 968,000 new cases are reported annually, accounting for 4.8% o","cbCaiesle3dOCb96","https://ap.wps.com/l/cbCaiesle3dOCb96","pdf",2717978,"English","# Introduction\n## Epidemiology and global burden\n## Correa cascade and disease progression\n## Chronic atrophic gastritis as a key precancerous condition","[{\"question\":\"What model is used to describe gastric carcinogenesis in the review?\",\"answer\":\"The review uses the Correa cascade, which outlines progression from chronic inflammation to atrophic gastritis, intestinal metaplasia, dysplasia, and ultimately invasive carcinoma.\"},{\"question\":\"Which molecular processes are emphasized for the transition toward gastric cancer?\",\"answer\":\"Key processes include inflammatory cytokine networks, epigenetic modifications, genomic instability, disruption of signaling pathways, clonal evolution, and remodeling of the tumor microenvironment.\"},{\"question\":\"How are biomarkers intended to improve clinical management?\",\"answer\":\"By integrating molecular biomarkers with conventional morphological assessment, the review suggests improved risk stratification, earlier detection of progression, and support for personalized prevention, surveillance, and treatment strategies.\"}]","Molecular Mechanisms and Biomarkers Driving the Transition From Chronic Atrophic Gastritis to Gastric Cancer | PDF",1790131730,48]