The Expression and Clinical Significance of Von Willebrand Factor (VWF) in Gastric Cancer Among Athletes: Insights for Sports Medicine

Abstract

Introduction: Gastric cancer remains one of the predominant gastrointestinal malignancies globally, posing significant diagnostic challenges. This study explores the expression of von Willebrand Factor (vWF) in gastric cancer among athletes, aiming to elucidate its clinical implications in this specific population.

Methods: Clinical data and RNA sequencing for vWF from gastric cancer patients were retrieved from the TCGA database. Correlation and survival analyses were conducted to examine the relationship between vWF expression and clinical risk factors at both overall and subgroup levels. Diagnostic efficacy of vWF and other baseline variables was assessed through ROC analysis. A logistic regression model was developed for prognosis and diagnostic purposes, focusing on oncological features and survival outcomes.

Results: The study included 318 gastric cancer patients, with 24 providing pairwise tissue samples. Elevated vWF mRNA expression was noted in cancerous tissues compared to normals. High vWF expression correlated with features common in athletes, such as male gender and physical stress, impacting areas like the antrum and gastric body. It was also associated with advanced disease stages and poor survival outcomes (P＜0.001). The prognosis prediction score (PPS) integrating age, vWF levels, and metastasis stage showed a strong correlation with poor prognosis. The model effectively predicted distant metastasis (AUC=0.942) and survival outcomes (AUC=0.675), with vWF primarily identifying survival outcomes (AUC=0.648).

Conclusion: In athletes with gastric cancer, vWF expression is significantly elevated and correlates with advanced disease and worse prognosis. The developed prognosis prediction score (PPS) and prediction probability (PP) models are promising tools for assessing clinical risk and prognosis in this population. These findings underscore the potential of vWF as a biomarker in sports medicine, aiding in the early detection and management of gastric cancer in athletes, facilitating timely and appropriate interventions.