Abstract
BACKGROUND: Gastric cancer remains a leading cause of cancer-related mortality worldwide. Both Helicobacter pylori (H. pylori) infection and alterations in serum gastrin levels have been implicated in its pathogenesis. However, their associations with tumor characteristics and clinical outcomes require further clarification. AIM: To investigate the associations of serum gastrin and H. pylori infection with pathology and prognosis in gastric cancer. METHODS: This hospital-based cohort study included 226 gastric cancer patients undergoing surgery and 100 matched controls from January 2019 to December 2023. Serum gastrin and H. pylori status were assessed and compared. Gastric cancer patients were stratified by biomarker status to analyze associations with tumor-nodes-metastasis (TNM) stage, lymph node metastasis, and tumor differentiation. Kaplan-Meier analysis was used to evaluate disease-free and overall survival (OS). Statistical significance was set at P < 0.05. RESULTS: Gastric cancer patients exhibited significantly higher serum gastrin levels and H. pylori infection rates than controls (P < 0.05). Among gastrin-positive patients, the proportions of advanced TNM stage (III-IV), lymph node metastasis, and poorly differentiated tumors were significantly higher than in gastrin-negative patients (P < 0.05). In contrast, H. pylori infection status showed no significant association with TNM stage, lymph node metastasis, or tumor differentiation (P > 0.05). Kaplan-Meier analysis indicated no significant difference in disease-free survival between gastrin-positive and negative patients (hazard ratio = 1.516, 95% confidence interval: 0.895-2.550), but gastrin-positive patients had significantly worse OS (hazard ratio = 2.717, 95% confidence interval: 1.311-5.633). CONCLUSION: Gastric cancer patients have elevated serum gastrin and higher H. pylori prevalence; elevated gastrin is associated with aggressive tumor features and poorer OS, indicating prognostic value.