{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T10:52:25Z","timestamp":1792666345907,"version":"4.5.0"},"reference-count":37,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T00:00:00Z","timestamp":1763596800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100017945","name":"Jilin Provincial Postdoctoral Science Foundation","doi-asserted-by":"publisher","award":["820241147428"],"award-info":[{"award-number":["820241147428"]}],"id":[{"id":"10.13039\/100017945","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82373664"],"award-info":[{"award-number":["82373664"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012326","name":"International Science and Technology Cooperation Programme","doi-asserted-by":"publisher","award":["20240402015 GH"],"award-info":[{"award-number":["20240402015 GH"]}],"id":[{"id":"10.13039\/501100012326","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Prognostic assessment plays a crucial role in guiding clinical management and treatment decisions for gastric cancer patients. The enrichment characteristics of 5-hydroxymethylcytosine (5hmC) in circulating cell-free DNA (cfDNA) has emerged as potential prognostic epigenetic markers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using 5hmC-Seal combined with next-generation sequencing (NGS), we profiled the genome-wide distribution of 5hmC in plasma cfDNA samples from 51 gastric cancer patients. Prognostic biomarkers were selected via random survival forest and Cox proportion hazards models, and a prognostic model was subsequently constructed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Seven prognostic biomarker genes were identified, and the 7-gene prognostic model demonstrated a concordance index (C-index) of 0.892 (95% CI\u2009=\u20090.786\u20130.998). Patients in the high risk group had a significantly worse overall survival (OS) than those in low-risk group (log-rank P\u2009=\u20090.00012). When the cfDNA 5hmC risk-score was integrated with the traditional clinical characteristics, the C-index increased from 0.819 (95% CI\u2009=\u20090.727\u20130.911) to 0.904 (95% CI\u2009=\u20090.853\u20130.955). Multivariate analysis adjusted for age, TNM stage, and chemotherapy confirmed that a high risk-score of cfDNA 5hmC model was an independent predictor of poor OS (hazard ratio [HR]=27.47, 95% CI\u2009=\u20093.28\u2013230.25).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>cfDNA 5hmC serves as an effective prognostic biomarker with high predictive value for the long-term survival in postoperative gastric cancer patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0335654","type":"journal-article","created":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T18:40:10Z","timestamp":1763664010000},"page":"e0335654","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["5-hydroxymethylcytosines from circulating cell-free DNA as noninvasive prognostic markers 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