Increased Slug and decreased E-cadherin expression is related to poor prognosis in patients with gastric cancer

Gastric Cancer. 2011 Mar;14(1):41-9. doi: 10.1007/s10120-011-0004-x. Epub 2011 Jan 28.


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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Cadherins / biosynthesis*
  • Female
  • Follow-Up Studies
  • Gastric Mucosa / metabolism
  • Humans
  • Immunoenzyme Techniques
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Prognosis
  • Snail Family Transcription Factors
  • Stomach Neoplasms / diagnosis
  • Stomach Neoplasms / metabolism*
  • Transcription Factors / biosynthesis*


  • Cadherins
  • SNAI1 protein, human
  • Snail Family Transcription Factors
  • Transcription Factors