Promoter methylation of IRF4 (p < 0.001), ELMO1 (p < 0.001), CLIP4 (p < 0.001), and MSC (p < 0.001), is strongly associated with increasing severity of disease in the histological progression from gastritis with no metaplasia, to gastritis with metaplasia, to gastric adenocarcinoma (Figure 3). This evidence concerns the gene IRF4 and gastric adenocarcinoma.