“… 117 In practice, however, it is not feasible to use gastric juice DNA for molecular diagnosis because DNA is easily damaged by stomach acid (strongly acidic, pH less than 3). 118 , 119 Watanabe et al have proposed an alternative to the highly acidic gastric juice for molecular analysis using gastric washes, which is the flushing fluid (gastric mucosa and normal saline) obtained during routine endoscopy. Of the six hypermethylated genes ( RORA , ADAM23 , MLF1 , MINT25 , GDNF , and PRDM5 ), GDNF and MINT25 are the most sensitive biomarkers for early GC, and in terms of gastric washes, the MINT25 site has the best specificity (95.8%) and sensitivity (90%).…”