Impact of Cholecystectomy on Gastric Mucosal c-MYC and h-TERT Expression; A Potential Link to Gastric Cancer Development

Gastric cancer is a multifactorial malignancy influenced by genetic and environmental factors. Cholecystectomy may lead to bile reflux, causing potential gastric mucosal injury. hTERT and c-MYC are key regulators in cellular proliferation and oncogenesis. Although epidemiological data generally indicate no strong association between cholecystectomy and gastric cancer, existing studies are limited and confounded by other risk factors. This study aimed to investigate the contribution of bile acid exposure post-cholecystectomy to gastric cancer development and to evaluate hTERT and c-MYC expressions. A total of 100 participants were enrolled at Manisa Celal Bayar University Hospital (September 2021–May 2023), categorized into gastric cancer (n=32), cholecystectomy (n=34), and control groups (n=34). Demographic data, Helicobacter pylori status, intestinal metaplasia presence, and gene expression levels were analyzed. Ethical approval and informed consent were obtained. Gene expression was assessed from endoscopic biopsy samples. Mean ages were higher in the cancer group (p<0.05). Female predominance was observed in the cholecystectomy group (p=0.021). No significant differences were found regarding H. pylori infection, intestinal metaplasia, or gene expressions related to metastasis. However, c-MYC and hTERT expressions were significantly lower in the cholecystectomy group compared to cancer and control groups (p<0.001). Female participants exhibited consistently lower gene expression levels than males (p<0.05). Although cholecystectomy was not directly linked to increased gastric cancer risk, it may contribute in genetically susceptible individuals. Reduced c-MYC and hTERT expressions suggest a potential role in future cancer risk stratification.