Georgian Scientists/ . 6 N 3, 2024 123 Georgian Scientists Vol. 6 Issue 3, 2024 https://doi.org/10.52340/gs.2024.06.03.13 , , , . , . , , , . , , . , : , . Helicobacter pylori - . , . , , , , , . : ; Helicobacter Pylor; ; ; , . 380 000 Georgian Scientists/ . 6 N 3, 2024 124 . 26,3 100 000 , . [1] 2022 (19 976 499) , 4.8%- (968 784) .[2] 50-80 , 50 . 2020 1.1 720 000 , 370 000 - , . [3] 2020 9 435 . 313 . , 68% (30-70) [4]. , , , . , 5 20%- . [5] 90%- . , , . [6] , , . , , , . [7] (Louren Classification) , , : (54%) (32%), , 15%- . , . , , , , . , , . , . , , . [8] Georgian Scientists/ . 6 N 3, 2024 125 (WHO) : , , . , . [9] , . , , - . , : , . Helicobacter pylori - . , . , , Helicobacter pylori- , , , , , , . [3] Helicobacter pylori . , H.pylori- , . 20%- , 2%- . [10] Helicobacter pylori- . . , . : CagA; CagPAI VacA. [11] , , . IL-1 . , , IL- 1B-31*C 511*C IL-1RN*2/*2 , H.pylori , . Georgian Scientists/ . 6 N 3, 2024 126 2-3- „ “. H.pylori- , , , , . , . , . , , . , [12]. (EMT) , , , , . - , . EMT , : , , , microRNA- . , . , , , . , . (CSC) . CSC- CD44 , , CD44 EMT- . , E-cadherin, CDH1 . EMT E-cadherin N-cadherin- , , , : . , - Georgian Scientists/ . 6 N 3, 2024 127 , , . EMT- , : Snail, Twist ZEB-1. E-cadherin . , Snail2 ZEB-1 , Snail1 Snail2 . , - . , , [12] , . [13] , , 1%- . , , , E- (CDH1) (CTNNA1) . , , . 20 1%- , 30 - 4%- , 50 20%- , - 45%- . , 5 4%- , 13%- . E- , , , , , Wnt - . , RAS/RAF/MARK PI3KA/AKT/mTOR. , , . , . KRAS 6.5%- , PI3KA 25%- . KRAS , NRAS . , Georgian Scientists/ . 6 N 3, 2024 128 , , MARK/ERK , EGFR, HER2, KRAS MET- 5 2- . [14] HER2- . erbB2, neu, p185 (EGFR) . . . 4.4%- 53,4%- , . , , , , , .[15] , , , , . , „ “ - . bcl-2 p53 . Bcl-2 , , p53- . , p53 - - , , , . , , [16]. Ki-67 - . Ki-67, , , . Ki-67 , G1, G2 S , G0 . , Ki-67- , , , , , . Georgian Scientists/ . 6 N 3, 2024 129 , , , Ki-67 LI <25% 12,4%- , Ki-67 LI 25-50% 25.9%- , Ki-67 LI 50- 75% 35,1%- , Ki-67 LI 75%> 26,7%- . , Ki-67 LI , . [17] , Ki-67 LI . 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Problematic issues of phenotypic characteristics and progression characteristics of gastric cancer and precancerous processes Beka Dangadze, Giorgi Didava, Anano Batselashvili, Giorgi Burkadze Tbilisi State Medical University A critical review Gastric carcinoma is the fourth most common malignancy and the second leading cause of cancer death worldwide. Stomach cancer kills many people in the world, so studying its initiation and development is very important. Diagnosing gastric cancer is directly related to timely endoscopic research. However, it is also important that most cases are already in the late stage due to the scarcity of early symptoms. Gastric cancer is a heterogeneous disease and is represented by different phenotypes, genotypes, complexity of the clinical course and low sensitivity to treatment. The heterogeneity of gastric cancer is due to many factors, which include genetic, environmental and various infectious agents. Most cases of stomach cancer are associated with Helicobacter pylori. Understanding the etiologic, epidemiologic, and various risk factors is essential for the timely diagnosis of gastric cancer and subsequent targeted Georgian Scientists/ . 6 N 3, 2024 132 treatment. Analysing the function of signalling pathways is important for developing personalised medicine. Since a rather heterogeneous genotype and phenotype characterise gastric cancer, it is, therefore, necessary to conduct more studies that include molecular-genetic analysis of cases, as this will help to detect the lesion at an early stage and subsequently manage individual cases better. And improving the patient's quality of life. Keywords: stomach cancer; Helicobacter pylori; progress; tumor heterogeneity; - PhD ; Beka Dangadze – PhD Student at Tbilisi State Medical University; - , George Didava – Associate Proffesor at Tbilisi State Medical University; E-mail: giorgi.didava10@gmail.com - ; Anano Batselashvili – Resident in Clinical and Anatomical Pathology at Tbilisi State Medical University E-mail: anano.batsilashvili@gmail.com Phone Number: +995599527116 - , ; George Burkadze - Professor at Tbilisi State Medical University, Head of the Department of Molecular Pathology; E-mail: burkadze@yahoo.com g.burkadze@tsmu.edu