Gastroesophageal Carcinogenesis


Cancer Programme

Group Leader

Manuel Ramón Pera Román

The sequential process prior to the appearance of a gastric or esophageal adenocarcinoma is a sequential histologically well-defined process characterized by the appearance of an intestinal phenotype. In the first stages of gastro-esophageal carcinogenesis the expression of intestinal markers, as intestinal transcription factors (CDX2), mucin genes (MUC2 and MUC4), intestinal enzymes and others, can be detected.

We study the molecular mechanisms that can be initiating these processes, through the regulation of transcription factors inducing the acquisition of the intestinal phenotype. In the esophagus, the development of columnar metaplasia (Barrett’s esophagus) is a response to a chronic gastroesophageal reflux injury and is a major risk factor for esophageal adenocarcinoma.

Patients undergoing esophagectomy with a gastric conduit reconstruction develop columnar metaplasia in the remnant esophagus on a background of significant reflux, providing a useful model to study the early molecular events in the development of Barrett’s esophagus. MiRNAs expression profiles may identify a characteristic signature that could distinguish between normal squamous epithelium, esophagitis, cardiac-type epithelium, and intestinal metaplasia.

We have identified miR24-3p as a negative regulator of CDX2, a transcription factor involved in the development of Barrett’s esophagus, in samples of cardiac-type mucosa with different stages of intestinalization.

We are currently analysing the value of a metabolic signature identified by a metabolomics approach as a biomarker for the early detection, treatment optimization, and follow-up of patients with gastroesophageal cancer.

 Research group


Gabriel Gil Gómez (Researher)

Mar Iglesias Coma (Researcher)

Marta Garrido Saldaña (Technician)


Main PublicationsOngoing Research ProjectsClinical Trials Signed in 2019Outreach 


Main Publications

• Jericó C, Osorio J, García-Erce JA, Pera MR. Patient Blood Management strategies for iron deficiency anemia management in gastric cancer. Eur J Gastroenterol Hepatol 2019; 31(4): 547-548. IF 2.198. Q3.

• Osorio J, Rodríguez-Santiago J, Roig J, Pera MR. Proyectos de estandarización del tratamiento del cáncer de la unión esofagogástrica: centralización, registros y formación. Cir Esp 2019; 97(8): 470-476. IF 0.835. Q4.

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Ongoing Research Projects

• Impacto de la fragilidad sobre los resultados postoperatorios de la cirugía del cáncer gástrico [TOREGA]

- Financing institution: Asociación Española de Cirujanos

- Period: from 2018 to 2020

- Principal investigator: Pera Román, Manuel Ramón

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Clinical Trials Signed in 2019

• Validación de la calidad de los datos del Registro EURECCA de Cáncer Esofagogástrico en España y resultados iniciales

- Protocol: EURECCA

- Sponsor: Fundació Institut Mar d'Investigacions Mèdiques

- Budget: No economic compensation

- Principal investigator: Pera Román, Manuel Ramón

• Distribution of lymph node metastases in esophageal carcinoma. TIGER study

- Sponsor: Amsterdam UMC (AMC)

- Budget: No economic compensation

- Principal investigator: Pera Román, Manuel Ramón



Conferences, Seminars and Courses

• Invited to deliver the prestigious conference “Diego Figuera Aymerich” at the 25 Congreso de la Sociedad Española de Investigaciones Quirúrgicas (SEIQ). Hospital Clínic, Barcelona, 12-13 December 2019.

Dissemination to Society and Initiatives of Citizen Participation

• Hoja de Ruta: Cáncer Gástrico. Fundación Más Que Ideas. Madrid, 21 June 2019.









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