The Association of Trefoil Factors with Gastric Cancer and Premalignant Lesions: A4 Cross-Sectional Population-Based Cohort Study

Background: A lack of research on the association of trefoil factors (TFFs) with gastriccancer (GC) and premalignant lesions (PMLs) in the general populations is an importantobstacle to the application of TFFs for GC screening. We aimed to analyze the associationof TFFs with GC and PMLs in a general population. Methods: We evaluated 3,986 adults residing in Wuwei, China. We collected baselinecharacteristics and GC risk factors, including TFFs, endoscopic diagnosis, and pathologicalinformation. Three logistic regression models were generated to analyze the associationbetween TFFs and GC, as well as PMLs. Adjusted odds ratio (OR) and 95% confidenceintervals (95% CI) were calculated to determine the strength of association. Results: Compared with pepsinogen (PG) and anti-Helicobacter pylori immunoglobulin Gantibody (Hp-IgG), TFFs had significant association with GC and PMLs after adjusting forbiomarkers and risk factors (P < 0.05). The ORs [95% CI] for TFF1 (1.67 [1.27–2.20]),TFF2 (2.66 [2.01–3.51]), and TFF3 (1.32 [1.00–1.74]) were larger than the ORs for PGI(0.79 [0.61–1.03]), PGI/II (1.00 [0.76–1.31]) and Hp-IgG (0.99 [0.73–1.35]) in the GCgroup. In intestinal metaplasia (IM) group, not only the TFF3 serum level was the highest,but also the OR (1.92 [1.64–2.25]) was the highest. Conclusions: Trefoil factor were associated with risk of GC and PMLs.Impact: Serum TFFs can improve the screening of high-risk populations for GC.