Objective To study the predictive value of adenosine monophosphate-activated protein kinase(AMPKα)and hepatocyte nuclear factor 4(HNF4)expression for local recurrence and distant metastasis after laparoscopic radical gastrectomy for gastric cancer.Methods Two hundred and ninety-four patients who underwent laparoscopic radical gastric cancer surgery admitted to Suining Central Hospital from January 2020 to August 2022 were selected.These patients were categorized into a recurrence and metastasis group(n=59)and a non-recurrence and non-metastasis group(n=235)based on postoperative local recurrence and distant metastasis.Gastric cancer tissue specimens obtained from surgical resection were used to detect and compare the cancer tissues of AMPKα mRNA and HNF4 mRNA between the two groups,and the data were statistically analyzed.Results The AMPKα mRNA and HNF4 mRNA in the recurrence and metastasis group were lower than those in the non recurrence and metastasis group(P<0.05);the point-biserial correlation showed that AMPKα mRNA(r=-0.816)and HNF4 mRNA(r=-0.803)were negatively correlated with postoperative local recurrence and distant metastasis(P<0.001),and the net correlation analysis showed that this relationship still existed after excluding confounding factors(P<0.001).Logistic regression analysis showed that AMPKα mRNA and HNF4 mRNA were postoperative local recurrence and distant metastasis related influencing factors(P<0.001);the interaction analysis showed that AMPKα mRNA and HNF4 mRNA were in a super multiplication model,and the decrease of HNF4 mRNA had a positive interaction effect on the decrease of AMPKα mRNA(P<0.05);the AUC of AMPKα mRNA+HNF4 mRNA was higher than that of AMPKα mRNA or HNF4 mRNA(Z=4.261,4.275,P<0.05).Conclusion Co-mbined detection of AMPKα and HNF4 expression can predict the risk of local recurrence and distant metastasis after laparoscopic radical gastrectomy for gastric cancer.