Background Gastric cancer (GC) is the fifth most common cancer globally and the third leading cause of cancer-related deaths.

Objective The aim of this study is to investigate the clinical significance and prognostic value of AKR7A3 in gastric cancer and to verify its impact on the biological functions of gastric cancer cells through in vitro cytological experiments.

Methods In the study, our investigations were performed using different databases and tools, including GEPIA, TCGA, GDSC and R software, to analyze the impact of AKR7A3 on clinical prognosis and medication effects. The CCK8 assay was used to detect cell proliferation, the scratch assay to measure cell migration, the Transwell assay to assess cell migration and invasion, and flow cytometry to evaluate apoptosis and cell cycle. The biological functions of AKR7A3 in gastric cancer cells were validated through in vitro cellular experiments.

Results The expression of AKR7A3 was down-regulated in GC tissues significantly. Furthermore, patients with low AKR7A3 expression group had shorter overall survival and worse disease-free survival (DFS) than those with high expression group. Based on the findings, AKR7A3 may able to have predictive value of clinical prognosis. AKR7A3 may contribute to gastric cancer progression through pathways such as Nitrogen metabolism signaling pathway. In addition, AKR7A3 was able to inhibit cell proliferation, promote apoptosis, suppress cell migration and increase MDA levels.

Conclusion AKR7A3 plays an important role in the prognosis, chemotherapeutic selection and the therapeutic efficacy in gastric cancer patients. As a tumour suppressor gene in gastric cancer cells, it can inhibit tumour cell proliferation and migration and promote apoptosis.