Integrative genetic and transcriptomic analyses prioritize CDC16 as a candidate marker for gastric cancer

BackgroundGastric cancer (GC) remains a major cause of cancer-related mortality, and biomarkers for early detection are needed.MethodsStomach and blood expression quantitative trait loci were integrated with two GC genome-wide association studies using Mendelian randomization (MR), Bayesian colocalization, and summary-data-based MR/heterogeneity in dependent instruments (SMR/HEIDI) testing. Bulk and single-cell transcriptomic analyses characterized candidate expression and lesion-associated patterns. CDC16 protein expression was evaluated by immunohistochemistry in 53 paired GC and non-neoplastic tissues, followed by paired and exploratory receiver operating characteristic analyses.ResultsMR prioritized PILRB, CDC16, and GABPB1-AS1; SMR/HEIDI provided complementary support, while colocalization for CDC16 and GABPB1-AS1 was suggestive and model-dependent. Bulk-tissue CDC16 abundance was higher in GC, but the modest TCGA-STAD tumor-normal difference (log2FC = 0.210, FDR = 0.019) was attenuated after proliferation adjustment (log2FC = -0.002, FDR = 0.987), indicating close coupling with proliferative activity. Single-cell analysis localized CDC16 predominantly to epithelial populations, and the proportion of CDC16-detectable epithelial cells increased across lesion categories (ρ = 0.735; permutation P = 0.031). CDC16 H-scores were higher in GC than in paired non-neoplastic tissues (161.15 ± 45.11 vs 102.15 ± 54.50; P < 0.001), with higher cancer-tissue scores in 41 of 53 cases. Exploratory AUC was 0.794 (95% CI, 0.704-0.874; sensitivity, 66.0%; specificity, 79.2%).ConclusionsConvergent genetic, transcriptomic, and protein-level evidence prioritizes CDC16 as a GC-associated candidate tissue marker whose expression is closely linked to proliferative activity. Prospective validation in independent cohorts, including appropriate disease controls and blood-based evaluation, is warranted.