Objective To investigate the expression of transcription factor forkhead box protein O (FOXO) genes in gastric cancer tissues and their correlation and clinical significance with Helicobacter pylori (Hp) infection.

Methods The expression levels of FOXOs genes (including FOXO1, FOXO3, FOXO4, and FOXO6) were detected by immunohistochemistry in cancer tissues and paracancerous tissues from 41 gastric cancer patients with Hp (−) and 29 gastric cancer patients with Hp (+) , as well as in gastric tissues from 30 healthy individuals. The correlation between FOXOs expression and Hp infection, clinical pathological features was analyzed. The relationship between FOXOs expression and survival prognosis of gastric cancer patients was analyzed using the Kaplan-Meier plotter.

Results Compared with those in the Hp(−) gastric cancer tissues, the expression levels of FOXO1, FOXO4, and FOXO6 were higher in the Hp(+) gastric cancer tissues (P<0.05). Meanwhile, the expression levels of FOXO1, FOXO3, and FOXO4 in the Hp(+) gastric cancer tissues were lower than that in the paracancerous tissues (P<0.05) and normal tissues (P<0.0001). The expression of FOXOs in gastric cancer tissues was closely correlated with the degree of differentiation, depth of infiltration, lymph node metastasis, and TNM stage of gastric cancer (P<0.05). Meanwhile, FOXO1/3 was associated with the survival prognosis of patients with gastric cancer.

Conclusion Hp infection promotes the expression of FOXO1/4/6 in gastric cancer tissues. The high expression of tumor suppressor genes FOXO1/4 may be one of the reasons for better prognosis in Hp (+) gastric cancer patients. FOXOs genes are widely involved in regulating the disease progression of gastric cancer, which has certain value for disease treatment.