Helicobacter pylori virulence gene expression defines a stage-associated transcriptional signature in gastric cancer

Figure 3 Validation and discriminative utility of the multigene transcriptional signature (n = 159). A: Odds ratios (OR) with 95%CIs are displayed. Blood group antigen-binding adhesin A (babA) (OR = 0.536) and induced by contact with epithelium gene A (OR = 0.802) are the only independent discriminators of advanced-stage disease that reach statistical significance (purple markers, P < 0.05); B: Comparison of Akaike information criterion scores indicates superior fit for the full panel (377) relative to the univariate (423.3) and dual-toxin (424.3) models; C: Receiver operating characteristic analysis shows that the combined signature (thick black line) reaches an area under the curve of 0.769 (apparent; falling to 0.747 on pooled 5-fold cross-validation) and performs better than the individual markers; D: Boxplots show a significant relationship between pathological stage and transcriptional scores (Spearman r = 0.494, P < 0.001), with babA downregulation providing the strongest association. ROC: Receiver operating characteristic; cagA: Cytotoxin-associated gene A; vacA: Vacuolating cytotoxin A; babA: Blood group antigen-binding adhesin A; iceA: Induced by contact with epithelium gene A.