title: Increased Slug and decreased E-cadherin expression is related to poor prognosis in patients with gastric cancer.
abstract: BACKGROUND
  The expression of E-cadherin correlates with the progression and metastasis of gastric cancer. Slug, a member of the snail family of transcriptional factors, is a newly identified factor that represses transcription of the E-cadherin gene. The purpose of the present study was to evaluate the clinical significance of E-cadherin and Slug expression in gastric cancer.
  
  
  METHODS
  Immunohistochemistry was used to investigate the expression of E-cadherin and Slug proteins in 164 patients with gastric cancer. The relationships between the expression of these proteins and clinicopathological factors, including prognosis, were analyzed.
  
  
  RESULTS
  Positive expression of E-cadherin and Slug was observed in 43.9 and 29.9% of cases, respectively. Tumors with reduced E-cadherin or positive Slug expression had greater extent of lymph node metastasis, lymphatic invasion, and venous invasion, and were at a worse stage than the tumors with preserved E-cadherin or negative Slug expression. Slug expression was significantly correlated with reduced E-cadherin expression; 37 of the 49 (75.5%) tumors with positive Slug expression had reduced E-cadherin expression (P = 0.0008). Patients with reduced E-cadherin expression or positive Slug expression had poor clinical outcomes. In the group with preserved E-cadherin expression, the 5-year survival rate was better for patients who were negative for Slug expression than for those who were positive for Slug expression (P = 0.0001). However, multivariate analysis indicated that E-cadherin expression and Slug expression were not independent prognostic factors.
  
  
  CONCLUSIONS
  Evaluation of not only the expression of E-cadherin, but also the coexpression of E-cadherin and Slug in patients with preserved E-cadherin expression would be useful for predicting malignant properties of gastric cancer.
authors.affiliation: Department of Surgical Oncology, Digestive Surgery, Graduate School of Medicine, Kagoshima University, Kagoshima, 890-8520, Japan. just-u@m.kufm.kagoshima-u.ac.jp
authors.forename: Yasuto
authors.initials: Y
authors.lastname: Uchikado
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Okumura
authors.forename: Sumiya
authors.initials: S
authors.lastname: Ishigami
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Setoyama
authors.forename: Masataka
authors.initials: M
authors.lastname: Matsumoto
authors.forename: Tetsuhiro
authors.initials: T
authors.lastname: Owaki
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Kita
authors.forename: Shoji
authors.initials: S
authors.lastname: Natsugoe
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D015820:Cadherins / Q000096:biosynthesis*; D005260:Female; D005500:Follow-Up Studies; D005753:Gastric Mucosa / Q000378:metabolism; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D000071250:Snail Family Transcription Factors; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000378:metabolism*; D014157:Transcription Factors / Q000096:biosynthesis*
chemical_list: D015820:Cadherins; C000604407:SNAI1 protein, human; D000071250:Snail Family Transcription Factors; D014157:Transcription Factors