胃肠道肿瘤是人类死亡的第二大原因，其特点是与炎症相关。目前，胃肠道肿瘤的早期诊断和有效治疗进展有限。最近的全基因组分析强调了它们深刻的异质性以及广泛的遗传和表观遗传重编程。表观遗传重编程涉及表观遗传模式的动态和可遗传的改变，缺乏潜在 DNA 序列的同时修改。常见的表观遗传修饰包括 DNA 甲基化、组蛋白修饰、非编码 RNA、RNA 修饰和染色质重塑。这些修饰具有激活或抑制多种与癌症相关的基因的潜力，从而控制以不同水平的可及性为特征的染色质构型的建立。这种复杂的相互作用在控制胃肠癌的发生和进展中发挥着关键且不可或缺的作用。本文重点讨论表观遗传重编程对胃癌、食道癌、结直肠癌以及其他罕见胃肠道肿瘤发生和进展的影响。我们阐明了胃肠道肿瘤的表观遗传景观，包括 DNA 甲基化、组蛋白修饰、染色质重塑及其相互关系。此外，这篇综述总结了表观遗传重编程的潜在诊断、治疗和预后目标，旨在协助临床治疗策略。© 2024 作者。四川国际医学交流中心出版的MedComm

Gastrointestinal tumors, the second leading cause of human mortality, are characterized by their association with inflammation. Currently, progress in the early diagnosis and effective treatment of gastrointestinal tumors is limited. Recent whole-genome analyses have underscored their profound heterogeneity and extensive genetic and epigenetic reprogramming. Epigenetic reprogramming pertains to dynamic and hereditable alterations in epigenetic patterns, devoid of concurrent modifications in the underlying DNA sequence. Common epigenetic modifications encompass DNA methylation, histone modifications, noncoding RNA, RNA modifications, and chromatin remodeling. These modifications possess the potential to invoke or suppress a multitude of genes associated with cancer, thereby governing the establishment of chromatin configurations characterized by diverse levels of accessibility. This intricate interplay assumes a pivotal and indispensable role in governing the commencement and advancement of gastrointestinal cancer. This article focuses on the impact of epigenetic reprogramming in the initiation and progression of gastric cancer, esophageal cancer, and colorectal cancer, as well as other uncommon gastrointestinal tumors. We elucidate the epigenetic landscape of gastrointestinal tumors, encompassing DNA methylation, histone modifications, chromatin remodeling, and their interrelationships. Besides, this review summarizes the potential diagnostic, therapeutic, and prognostic targets in epigenetic reprogramming, with the aim of assisting clinical treatment strategies.© 2024 The Author(s). MedComm published by Sichuan International Medical Exchange & Promotion Association (SCIMEA) and John Wiley & Sons Australia, Ltd.