Abstract
The peritoneum is the most common site of recurrence of gastric cancer (GC). Early occult peritoneal metastasis is difficult to detect by imaging examination. Stratifying the risk of peritoneal metastasis in patients with different Lauren subtypes is of great clinical value. We performed a univariate Cox regression to identify those genes with prognostic value of overall survival (OS) and peritoneal-specified disease-free survival (psDFS) from the Gene Expression Omnibus database. The candidate genes were screened by the Subpopulation Treatment Effect Pattern Plot (STEPP) method. Propensity score matching (PSM) analysis was used to reduce the interference of confounders on the results. Based on the optimal cut-off values determined by the STEPP method, we found overexpression of three genes (HAND2-AS1, PRKAA2, and VLDLR) was correlated with shorter 1-year psDFS among patients with diffuse-type than that of patients with intestinal-type GC, and it is highly significant. Gene Set Enrichment Analysis (GSEA) potentially suggested that the three genes promote the early occurrence of peritoneal metastasis in patients with diffuse-type GC through glucose metabolism-related pathways. These three genes may be potential biomarkers. They can be used to assess the risk of peritoneal metastases to guide treatment decisions and follow-up strategies.
Highlights
Gastric cancer (GC) is the fifth most common and lethal cancer in males and females globally and metastasis is its main cause of death (Arnold et al, 2020; Zhang et al, 2020b)
The following are the inclusion criteria for this study: (1) the patient is older than 18 years; (2) histopathological confirmation of gastric cancer; (3) patients with Lauren classification information; (4) primary gastric cancer tumor specimens at the time of total or subtotal gastrectomy
The results showed that the correlation of any two of these three genes was statistically significant, but the lower correlation coefficient indicated that their degree of association was not strong
Summary
Gastric cancer (GC) is the fifth most common and lethal cancer in males and females globally and metastasis is its main cause of death (Arnold et al, 2020; Zhang et al, 2020b). Around 40% of GC patients have distant metastases at the time of diagnosis (Imaoka et al, 2016; Riihimäki et al, 2016). The peritoneum is the most common site of metastases and recurrences in patients with GC (Nishina et al, 2016; Sawaki et al, 2020). Staging laparoscopy can make early diagnosis and tailor-made treatment of peritoneal metastasis, which is great progress in clinical diagnosis of early peritoneal metastasis (Rawicz-Pruszyński et al, 2019). These examinations do not always provide reliable diagnoses or accurate prognostic predictions, accurate and less invasive predictive methods are urgently needed
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