The onset and evolution of GC is a multifactorial, multigenetic, and multistage process, with invasion and metastasis being the main causes of death.9,10 Research has shown that miRNA-499 rs3746444 A/G polymorphism serves as a biomarker for predicting the recurrence of primary early GC after endoscopic submucosal dissection.11 In addition, it was demonstrated that GC cell-derived exosomes aggravated GC by transferring TTN-AS1 to GC cells via the miR-499a-5p/ZEB1/CDX2 axis.12 Earlier studies implicated miR-499a-5p in GC, but studies on its specific expression and role in GC are scarce. Here, TTN is linked to gastric cancer.