In GC patients with a high TMB, the most significantly mutated genes were LRP1B (79.07%), ARID1A (74.42%), RNF43(69.77%), ZFHX3(65.12%), TP53(58.14%), GANS (51.16%), BRCA2(51.16%), PIK3CA (51.16%), NOTCH1 (51.16%), SMARCA4 (48.84%), ATR (46.51%), POLE (41.86%) and ATM (39.53%) (Fig. 5). The gene discussed is RNF43; the disease is gastric cancer.