To investigate the expression of appetite inhibitory factor-1/precursor nucleoprotein 2 (Nesfatin-1/NUCB2) in early gastric cancer associated with Helicobacter pylori (H. pylori) infection and to analyze its clinical significance.

Eighty patients with early gastric cancer associated with H. pylori infection who were hospitalized at the Department of Gastroenterology of Anqing First People's Hospital from January 2017 to February 2018 were selected as research subjects. The expression levels of Nesfatin-1/NUCB2 in tumor and tumor-adjacent tissues of the patients were compared. All patients were divided into a Nesfatin-1/NUCB2 positive group and a Nesfatin-1/NUCB2 negative group according to the expression status of Nesfatin-1/NUCB2 in gastric cancer tissue, and the relationship between Nesfatin-1/NUCB2 expression and clinicopathological characteristics was analyzed. Multivariate Cox regression analysis was conducted to identify independent predictors of postoperative tumor recurrence/metastasis and death in patients with Hp-associated early gastric cancer. The correlation between Nesfatin-1/NUCB2 and postoperative tumor recurrence/metastasis and death were analyzed, and ROC curve analysis was performed to predict postoperative tumor recurrence, metastasis, and death in the patients. The postoperative disease-free survival rate and overall survival rate between the two groups were compared by the Kaplan-Meier method.

The relative expression of Nesfatin-1/NUCB2 mRNA in tumor tissue was (0.53±0.12), which was significantly higher than that in adjacent tissues (0.12±0.03; P＜0.05). Carcinoembryonic antigen and the proportions of patients with low differentiation, submucosal invasion, lymph node metastasis, and neurovascular invasion were significantly higher in the Nesfatin-1/NUCB2 positive group than in the Nesfatin-1/NUCB2 negative group (P＜0.05). Multivariate Cox regression analysis showed that neurovascular invasion, depth of invasion, lymph node metastasis, and Nesfatin-1/NUCB2 expression were independent predictors of postoperative tumor recurrence/metastasis and death (P＜0.05). ROC curve analysis showed that the area under the curve of the combination of neurovascular invasion, depth of invasion, lymph node metastasis, and Nesfatin-1/NUCB2 expression for predicting postoperative recurrence/metastasis and death were 0.923 (95%CI: 0.901~0.967) and 0.918 (95%CI: 0.895~0.959), respectively. Kaplan-Meier survival analysis showed that the 1-year, 3-year, and 5-year disease-free survival rates and overall survival rates of patients in the Nesfatin-1/NUCB2 negative group were significantly higher than those in the Nesfatin-1/NUCB2 positive group (P＜0.05).

Nesfatin-1/NUCB2 positive patients with H. pylori-associated arly gastric cancer have a higher risk of postoperative tumor recurrence/metastasis and low disease-free survival and overall survival rates.