Abstract: Objective To investigate the gain value of the combined expression of phospholipase C ε1 (PLCE1) mRNA,Src homology domain 3 protein 1 (LASP1) mRNA,and cyclindependent kinase 12 (CDK12) mRNA in predicting early disease progression after endoscopic submucosal dissection (ESD) for gastric cancer.Methods The clinical data of 184 patients diagnosed with gastric cancer in our hospital from January 2021 to May 2023 who underwent ESD surgery were retrospectively analyzed,Patients were divided into disease progression group（26 cases） and non-disease progression group（158 cases） according to whether their condition progressed one year after surgery.Real-time fluorescence quantitative PCR was used to detect and compare PLCE1 mRNA,LASP1 mRNA,and CDK12 mRNA in cancer tissues and paracancer tissues (2 cm away from the tumor lesions) of the two groups.The impact of PLCE1,LASP1,and CDK12 gene expression on early disease progression after ESD in gastric cancer was analyzed using a Multivariate logistic regression equation.The value of PLCE1 mRNA,LASP1 mRNA,CDK12 mRNA,and their combined prediction for early disease progression after ESD of gastric cancer was analyzed using receiver operating characteristic (ROC) curve analysis.Results The proportion of patients with superficial submucosal infiltration and ulceration in the disease progression group was higher than that in the non-disease progression group (P<0.05).The levels of PLCE1 mRNA,LASP1 mRNA,and CDK12 mRNA in the cancer tissues of both groups were higher than those in the tissues adjacent to the cancer (P<0.05).The levels of PLCE1 mRNA,LASP1 mRNA,and CDK12 mRNA in cancer tissues from the disease progression group were higher than those in the non-disease progression group (P<0.05).Multivariate analysis showed that the increase in PLCE1 mRNA,LASP1 mRNA,and CDK12 mRNA were independent factors associated with early disease progression after ESD in gastric cancer (P<0.001).Each increase of 1 unit in these three factors increased the risk of early disease progression by 1.318,1.226,and 1.352 times,respectively.In ROC analysis,the AUCs of PLCE1 mRNA,LASP1 mRNA,and CDK12 mRNA for predicting early disease progression after ESD in gastric cancer were 0.815,0.750,and 0.792,respectively.The AUC of PLCE1 mRNA + LASP1 mRNA + CDK12 mRNA for predicting early disease progression after ESD in gastric cancer was 0.935 (95%CI:0.889~0.966),which was higher than that of PLCE1 mRNA (Z=2.816,P=0.041).The sensitivity of combined prediction was 92.31%,and the specificity was 85.44%.Conclusion The gene expression of PLCE1,LASP1,and CDK12 in surgical specimens is independently associated with early disease progression after ESD of gastric cancer.Combined detection of the three genes can improve the gain value of early disease progression after ESD of gastric cancer.

Key words: PLCE1, LASP1, CDK12, gene, gastric cancer, endoscopic submucosal dissection, early disease progression after operation, predictive effectiveness