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World J Gastroenterol. May 28, 2026; 32(20): 117044
Published online May 28, 2026. doi: 10.3748/wjg.v32.i20.117044
Published online May 28, 2026. doi: 10.3748/wjg.v32.i20.117044
Gastric microenvironment and gastric cancer: Interplay of acid, microbiota, and inflammation
Hao-Cheng Zheng, Xia Ding, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100062, China
Ting Zhou, Lei Sun, Xia Ding, School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing 102488, China
Co-first authors: Hao-Cheng Zheng and Ting Zhou.
Co-corresponding authors: Lei Sun and Xia Ding.
Author contributions: Zheng HC wrote the first draft of the manuscript. Zhou T was responsible for literature search, data organization and figure preparation. Both Zheng HC and Zhou T made important contributions to the manuscript preparation and therefore qualified as the co-first authors. Both Sun L and Ding X have played important and indispensable roles in the conception, scientific revision and manuscript preparation as the co-corresponding authors. Sun L was mainly responsible for critically revising the manuscript for scientific accuracy and academic rigor, providing overall quality control of the final version, and obtaining funding support for this study. Ding X proposed the core idea and overall scientific framework of this review, provided funding support, guided the literature structure and narrative logic, and performed the final proofreading and approval of the manuscript before submission. This close collaboration between Sun L and Ding X was essential for the completion and publication of this manuscript, and therefore they are designated as co-corresponding authors.
AI contribution statement: ChatGPT and Grammarly was used solely for language polishing and minor editing to improve clarity and readability. No other AI tools were used. The authors declare that AI tools were used only for limited language polishing to improve clarity and readability of the manuscript. All scientific content, including the study design, data generation, analysis, interpretation, and writing of the manuscript, was performed entirely by the authors. No part of the main text was generated by AI. All figures and images were created manually without the use of AI.
Supported by the National Natural Science Foundation of China, No. 82374292; the Noncommunicable Chronic Diseases-National Science and Technology Major Project, No. 2025ZD0545100; the Innovation Team and Talents Cultivation Program of the National Administration of Traditional Chinese Medicine, No. ZYYCXTD-C-202401; the Plans for Major Provincial Science & Technology Projects of Anhui Province, No. 202303a07020003; the Fundamental Research Funds for the Central Universities of Beijing University of Chinese Medicine, No. 2025-JYB-JBGS-025; and Graduate Students’ Independent Scientific Research Project, Beijing University of Chinese Medicine, No. ZJKT2025004.
Conflict-of-interest statement: The authors declare no conflict of interest.
Corresponding author: Xia Ding, MD, PhD, Professor, School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, No. 11 North Third Ring East Road, Chaoyang District, Beijing 102488, China. dingx@bucm.edu.cn
Received: December 1, 2025
Revised: December 30, 2025
Accepted: March 2, 2026
Published online: May 28, 2026
Processing time: 174 Days and 15.8 Hours
Revised: December 30, 2025
Accepted: March 2, 2026
Published online: May 28, 2026
Processing time: 174 Days and 15.8 Hours
Core Tip
Core Tip: Gastric microenvironment is shaped by gastric acid secretion, microbiota composition, and mucosal inflammation, which collectively drive the progression from gastritis to metaplasia and gastric cancer. Their bidirectional interactions create a self-reinforcing cycle of hypochlorhydria, microbial dysbiosis, and chronic inflammation. This comprehensive review provides an integrated perspective on these processes, offering updated insights into pathogenic mechanisms, risk stratification, and potential preventive or therapeutic strategies.