Consistent with previous studies [34, 35], in our cohort of patients, TP53 was the most frequently altered gene (52%), followed by other tumor suppressor mutated genes, such as FBW7, RNF43 and ARID1A, already identified as biomarkers for early GC carcinogenesis, determinants for the progression of intestinal metaplasia to gastric cancer and worst prognosis [36–38]. This evidence concerns the gene RNF43 and gastric cancer.