Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Clin Oncol. Oct 24, 2026; 17(10): 125453
Published online Oct 24, 2026. doi: 10.5306/wjco.125453
Published online Oct 24, 2026. doi: 10.5306/wjco.125453
Helicobacter pylori virulence gene expression defines a stage-associated transcriptional signature in gastric cancer
Oliver Mbuthia, Department of Medical Microbiology and Immunology, University of Nairobi, Kenyatta National Hospital, Nairobi P O Box 30197-00100, Nairobi City, Kenya
Ishrat Mahjabeen, Mahmood Kayani, Azhar Mehmood, Department of Biosciences, COMSATS University Islamabad, Islamabad 45550, Pakistan
Jael Obiero, Department of Reproductive Health and Biology, Kenya Institute of Primate Research, Nairobi P O Box 24481-00502, Nairobi City, Kenya
Takashi Matsumoto, Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, Yufu 879-5593, Japan
Kefa Bosire, Department of Pharmacy and Pharmacognosy, University of Nairobi, Nairobi P O Box 30197-00100, Kenya
Marianne Mureithi, KAVI - Institute of Clinical Research, University of Nairobi, Nairobi P O Box 30197-00100, Kenya
Author contributions: Mbuthia O conceived and designed the study, established the analytical methodology, obtained funding, conducted the formal analysis, curated the data, and prepared the initial manuscript draft; Mahjabeen I participated in sample and data collection, supplied laboratory resources, and contributed to methodology and data curation; Kayani M supervised the project, provided essential resources and administrative support, and critically revised the manuscript; Mehmood A participated in data collection and curation, supplied resources, and critically revised the manuscript; Bosire K contributed to methodology, supervision, and critical manuscript revision; Matsumoto T contributed to methodology, validation, supervision, and critical manuscript revision; Obiero J contributed to study methodology and validation, supervised the work, and critically revised the manuscript; Mureithi M contributed to study design, supervision, and manuscript revision; and all authors read and approved the final version of the manuscript.
AI contribution statement: The authors declare that generative artificial intelligence tools were not used to generate data or conduct formal statistical analysis in this study. Google Gemini was used for language alignment and editing of the initial manuscript draft, and Claude (Anthropic) was used for language editing and manuscript refinement during subsequent revisions, including improvements to grammatical clarity, sentence structure, and terminological consistency. This use did not alter the scientific content, interpretation of the data, or conclusions, for which the authors retain sole responsibility.
Supported by the United Nations Educational, Scientific and Cultural Organization - The World Academy of Sciences and COMSATS University Islamabad, No. 3240320712.
Institutional review board statement: Approval for the study protocol was obtained from the Institutional Review Board of COMSATS University Islamabad and from participating clinical centers [Ref: CIIT/Bio/ERB/17/15]. All study procedures conformed to the Declaration of Helsinki. Gastric biopsy specimens were collected only after patients had provided written informed consent for use of their samples in molecular research.
Informed consent statement: Before sample collection, written informed consent was obtained from every participant for use of gastric biopsy specimens in molecular research. Participant confidentiality was protected by de-identifying all specimens and assigning a unique study ID before analysis.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: Data generated and/or analyzed in the current study are available from the corresponding author on reasonable request.
Corresponding author: Oliver Mbuthia, PhD, Department of Medical Microbiology and Immunology, University of Nairobi, Kenyatta National Hospital, Nairobi P O Box 30197-00100, Nairobi City, Kenya. oliver.mbuthia@nairobi.msf.org
Received: July 9, 2026
Revised: August 26, 2026
Accepted: October 8, 2026
Published online: October 24, 2026
Processing time: 107 Days and 10.1 Hours
Revised: August 26, 2026
Accepted: October 8, 2026
Published online: October 24, 2026
Processing time: 107 Days and 10.1 Hours
Core Tip
Core Tip: Standard diagnostic approaches for Helicobacter pylori generally establish whether the organism is present but do not resolve heterogeneity within gastric cancer. This study evaluates an expression-based discrimination model using a combined four-gene virulence transcript signature (cytotoxin-associated gene A, vacuolating cytotoxin A, blood group antigen-binding adhesin A, and induced by contact with epithelium gene A). The model identifies a stage-associated “adherence-to-invasion” transcriptional shift and, through a decision-tree classifier, discriminates early from advanced clinical stages with an area under the curve of 0.867, falling to 0.68 on nested cross-validation, a promising but modest signal warranting external validation.