Systemic Molecular Network Alterations Associated with FoxA2 in Gastric Cancer

Gastric cancer is a multifactorial disease characterized by complex interactions among transcriptional regulation, inflammation, metabolic adaptation, and angiogenesis. However, systemic molecular relationships linking these processes remain insufficiently understood. This study aimed to evaluate circulating levels of FOXA2 (Forkhead Box A2), Ang-1 (Angiopoietin-1), ApoE4 (Apolipoprotein E4), PEN-2 (Presenilin Enhancer-2), and NF-κB (Nuclear Factor kappa B) in gastric cancer patients and to explore their potential integrated role in disease biology. Serum samples were obtained from 40 patients with gastric cancer (20 preoperative and 20 postoperative) and 20 healthy controls. Protein levels were measured using enzyme-linked immunosorbent assay (ELISA), followed by statistical analysis. Serum levels of FOXA2, ApoE4, PEN-2, and NF-κB were significantly decreased in gastric cancer patients compared with healthy controls, whereas Ang-1 levels were significantly increased. No statistically significant differences were observed between preoperative and postoperative groups. These findings indicate coordinated dysregulation of transcriptional, inflammatory, metabolic, and angiogenic processes in gastric cancer. The identified FOXA2-NF-κB-PEN-2-ApoE4-Ang-1 axis may be considered an integrated circulating molecular profile reflecting tumor host interactions and may provide a potential foundation for future non-invasive biomarker development and translational research. This study proposes systems-level circulating molecular network model rather than isolated biomarker alterations.