Figure 2. Interactions Among Inflammation, Bacteria, and the Epithelium Leading to Gastric Cancer.

We show the interaction of H pylori, environmental factors, and inflammation in the pathogenesis of gastric cancer. Each plays important roles leading to progressive chromosome instability. H pylori-induced inflammation leads to high gastric endothelial cell turnover and a microenvironment that is high in reactive oxygen and nitrogen species, increasing opportunities for DNA damage and somatic mutations. ROS = Reactive oxygen species. Adapted from references ^{3, 28}