Background: A lack of research on the association of trefoil factors (TFFs) with gastric
cancer (GC) and premalignant lesions (PMLs) in the general populations is an important
obstacle to the application of TFFs for GC screening. We aimed to analyze the association
of TFFs with GC and PMLs in a general population.
Methods: We evaluated 3,986 adults residing in Wuwei, China. We collected baseline
characteristics and GC risk factors, including TFFs, endoscopic diagnosis, and pathological
information. Three logistic regression models were generated to analyze the association
between TFFs and GC, as well as PMLs. Adjusted odds ratio (OR) and 95% confidence
intervals (95% CI) were calculated to determine the strength of association.
Results: Compared with pepsinogen (PG) and anti-Helicobacter pylori immunoglobulin G
antibody (Hp-IgG), TFFs had significant association with GC and PMLs after adjusting for
biomarkers and risk factors (P < 0.05). The ORs [95% CI] for TFF1 (1.67 [1.27–2.20]),
TFF2 (2.66 [2.01–3.51]), and TFF3 (1.32 [1.00–1.74]) were larger than the ORs for PGI
(0.79 [0.61–1.03]), PGI/II (1.00 [0.76–1.31]) and Hp-IgG (0.99 [0.73–1.35]) in the GC
group. In intestinal metaplasia (IM) group, not only the TFF3 serum level was the highest,
but also the OR (1.92 [1.64–2.25]) was the highest.
Conclusions: Trefoil factor were associated with risk of GC and PMLs.
Impact: Serum TFFs can improve the screening of high-risk populations for GC.