Plasma proteomic profiling of gastric cancer: Super minimally invasive surgery vs organ-resection on trauma immunity

doi:10.3748/wjg.v32.i16.117799

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World Journal of Gastroenterology

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1007-9327

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World J Gastroenterol. Apr 28, 2026; 32(16): 117799
Published online Apr 28, 2026. doi: 10.3748/wjg.v32.i16.117799

Plasma proteomic profiling of gastric cancer: Super minimally invasive surgery vs organ-resection on trauma immunity

Yao-Qian Yuan, Qian-Qian Chen, Pan Xiao, Hui-Kai Li, Kun-Ming Lv, Shuai Tian, Hui Shi, Jing Hao, Yang Yan, En-Qiang Linghu

Yao-Qian Yuan, Qian-Qian Chen, Pan Xiao, Hui-Kai Li, Kun-Ming Lv, Shuai Tian, Jing Hao, En-Qiang Linghu, Department of Gastroenterology, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China

Kun-Ming Lv, Hui Shi, Department of Gastroenterology, The Second Medical Center of Chinese PLA General Hospital, Beijing 100853, China

Yang Yan, Department of General Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China

Co-first authors: Yao-Qian Yuan and Qian-Qian Chen.

Co-corresponding authors: Yang Yan and En-Qiang Linghu.

Author contributions: Yuan YQ and Chen QQ made equal contributions as co-first authors; Linghu EQ and Chen QQ contributed to conceptualization and supervision; Yuan YQ and Xiao P contributed to experiments; Yuan YQ, Li HK, Lv KM, Tian S, Shi H, and Hao J contributed to data collection and analysis; Yan Y contributed to literature review; Yuan YQ contributed to writing draft; Linghu EQ, Chen QQ, Li HK, Yan Y, Shi H, and Hao J contributed to surgical procedures; Linghu EQ and Yan Y made equal contributions as co-corresponding authors. All authors approved the final format of the submitted manuscript.

Supported by National Key Research and Development Program of China, No. 2022YFC2503601.

Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of the Chinese PLA General Hospital, No. S2023-188-01.

Clinical trial registration statement: This study is registered at Chinese Clinical Trial Registry, No. ChiCTR2500097111.

Informed consent statement: Written informed consent was obtained from all individual participants included in the study.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.

Data sharing statement: The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Corresponding author: En-Qiang Linghu, MD, Chief Physician, Professor, Department of Gastroenterology, The First Medical Center of Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China. linghuenqiang@vip.sina.com

Received: December 16, 2025
Revised: January 18, 2026
Accepted: February 12, 2026
Published online: April 28, 2026
Processing time: 121 Days and 18.1 Hours

Abstract

BACKGROUND

Gastric cancer remains one of the leading causes of cancer-related mortality worldwide, and surgery remains the cornerstone of curative treatment. However, the extent of surgical resection may significantly influence postoperative immune and inflammatory responses, which are closely related to recovery and complication rates.

AIM

To compare the effects of super minimally invasive surgery (SMIS) and organ-resection surgery (ORS) for gastric cancer on postoperative immune and inflammatory responses.

METHODS

This prospective study included patients with gastric cancer who underwent SMIS or conventional ORS between May 2023 and April 2024. Peripheral blood samples were collected one day preoperatively and on the third postoperative day. Plasma levels of 92 trauma- and immunity-related proteins were quantified using the Olink proteomic platform. Differentially expressed proteins (DEPs) before and after surgery were identified within each group, and comparative analyses were performed to assess immune-inflammatory alterations between SMIS and ORS.

RESULTS

A total of 38 patients were included: 20 in the SMIS group and 18 in the ORS group. Baseline demographic and clinical characteristics were comparable between the groups (all P > 0.05). Proteomic analysis identified 13 DEPs after SMIS and 37 DEPs after ORS. Nine DEPs were shared between the surgical models (TMPRSS15, CNTN2, HPGDS, PLXDC1, NPPC, CA14, calcitonin, platelet-derived growth factor C, and nitric oxide synthase). Among these, calcitonin, platelet-derived growth factor C, and nitric oxide synthase showed the most prominent postoperative upregulation, particularly after ORS, indicating a stronger trauma-related immune response than SMIS.

CONCLUSION

SMIS for gastric cancer was associated with a reduced postoperative immune-inflammatory response and lower trauma-related protein expression than ORS, suggesting better immune preservation and lower surgical stress.

Keywords: Gastric cancer; Organ-resection surgery; Super minimally invasive surgery; Trauma immunity; Inflammatory response

Core Tip: The optimal extent of surgical intervention for gastric cancer remains controversial, particularly with respect to its impact on postoperative immune homeostasis. This study integrates super minimally invasive surgery concepts with proteomic profiling to investigate immune-inflammatory alterations following different surgical strategies, providing mechanistic insights that may support more individualized, trauma-conscious surgical decision-making in early gastric cancer.