对早期胃腺癌（GAC）进行内镜治疗并根除幽门螺杆菌（H. pylori）后异时复发（MR）的机制尚不清楚。为了阐明 MR 的机制和危险因素，我们分析了胃粘膜多个位置的基因表达。在早期 GAC 治疗和根除幽门螺杆菌后，我们选择了每 5 名有 MR 和无 MR 的患者（对照）。从每位患者胃的四个部位收集粘膜组织作为活检标本，用于 mRNA 测序、基因集富集分析和 microRNA (miRNA) 测序。我们还对路径进行了相关分析和目标预测。结果，在内镜下，MR组有更多的肠化生和扩大的皱襞。 MR组中共有384个mRNA出现表达变化，并且富集了31个基因集。免疫相关通路在整个胃中富集，其中IFN-α反应的富集分数最高。此外，32 个 miRNA 的表达发生了变化。与 IFN-α 反应基因组中基因的相关性分析和目标预测显示，10 个 miRNA-mRNA 对呈现显着相关性。幽门螺杆菌根除后胃粘膜中 miRNA 的免疫相关通路可能是 MR 的危险因素。© 2023。作者。

The mechanism of metachronous recurrence (MR) after performing endoscopic treatment for early gastric adenocarcinoma (GAC) and eradicating Helicobacter pylori (H. pylori) is unknown. To elucidate the mechanism and risk factors of MR, we analyzed gene expression at multiple locations of the gastric mucosa. We selected each five patients with MR and without MR (control), after early GAC treatment and eradication of H. pylori. Mucosal tissue was collected from four sites in the stomach of each patient as biopsy specimens for mRNA sequencing, gene set enrichment analysis, and microRNA (miRNA) sequencing. We also performed correlation analysis and target prediction on pathways. As a result, endoscopically, the MR group had more intestinal metaplasia and enlarged folds. A total of 384 mRNAs presented changes in expression and 31 gene sets were enriched in the MR group. Immune-related pathways were enriched in the entire stomach, and the IFN-α response had the highest enrichment score. Additionally, 32 miRNAs revealed changes in their expression. Correlation analysis and target prediction with genes in the gene set of IFN-α response revealed that 10 miRNA-mRNA pairs presented a significant correlation. Immune-related pathways with miRNAs in the gastric mucosa after H. pylori eradication may be a risk factor for MR.© 2023. The Author(s).