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Clinical and Translational Oncology

, Volume 16, Issue 9, pp 783–791 | Cite as

Snail1 correlates with patient outcomes in E-cadherin-preserved gastroesophageal junction adenocarcinoma

  • H. Dong
  • L. Xie
  • C. Tang
  • S. Chen
  • Q. Liu
  • Q. Zhang
  • W. Zheng
  • Z. Zheng
  • H. Zhang
Research Article

Abstract

Purpose

The poor prognosis of gastroesophageal junction (GEJ) adenocarcinoma is largely associated with metastasis. We here report the first study to investigate the expression of epithelial-mesenchymal transition (EMT) markers Snail1 and E-cadherin in GEJ adenocarcinoma.

Methods

Snail1 and E-cadherin were detected by immunohistochemistry in a cohort of 128 patients with surgically resected GEJ adenocarcinoma. We assessed the pathologic and prognostic relevance in all patients and within clinically different preserved E-cadherin and reduced E-cadherin-expressing sub-groups.

Results

Immunoreactivity for Snail1 and E-cadherin was positive in 68 and 43 % of tumors, respectively. Snail1-positive tumors had more frequent lymph node metastasis and advanced tumor stage. E-cadherin expression was highly associated with histological differentiation, tumor size, advanced stage, presence of lymph node metastasis and distant metastasis. Patients with positive E-cadherin expression or negative Snail1 expression had significantly favorable overall survival rate. In E-cadherin-preserved tumors, the expression of Snail1 was related to lymph node metastasis, advanced stage and poor patient outcome. However, Snail1 expression had no statistically significant relationship with clinicopathologic parameters or prognosis in the reduced E-cadherin-expressing sub-group. Multivariate survival analysis identified that tumor stage [hazard ratio (HR) 2.440; 95 % confidence interval (CI) 1.216–4.896; P = 0.012], lymph node metastasis (HR 2.404; 95 % CI 1.188–4.867; P = 0.015) and gender (HR 3.244; 95 % CI 1.568–6.714; P = 0.002) were independent prognostic markers for overall survival.

Conclusions

Snail1 may act more critically in E-cadherin-positive tumors. Evaluation of Snail1 and E-cadherin in GEJ adenocarcinoma may help in assessing malignant properties and stratifying patients.

Keywords

Snail1 E-cadherin Epithelial-mesenchymal transition Gastroesophageal junction adenocarcinoma 

Notes

Acknowledgments

This work was supported in part by National Natural Science Foundation of China grants 30973508, 81071736 (H. Zhang) and 81171994 (L. Xie); Fund for University Students Innovation Program of Guangdong Province 1056010001 (W. Zheng).

Conflict of interest

No potential conflicts of interest are disclosed.

Supplementary material

12094_2013_1149_MOESM1_ESM.pdf (275 kb)
Fig. S1 GEJ adenocarcinoma tissue sections immunostained with goat IgG instead of Snail1 antibody as negative control (×400). (PDF 275 kb)
12094_2013_1149_MOESM2_ESM.pdf (165 kb)
Fig. S2 Kaplan–Meier analysis showing the overall survival of GEJ adenocarcinoma patients categorized according to the clinical stage. Statistical significance of the difference between curves of Snail1 negative-expressing and positive-expressing patients was compared in clinical stage I to II (a) and clinical stage III (b) patient subgroups. Statistical significance of the difference between curves of E-cadherin negative-expressing and positive-expressing patients was compared in clinical stage I to II (c) and clinical stage III (d) patient subgroups. (PDF 166 kb)

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Copyright information

© Federación de Sociedades Españolas de Oncología (FESEO) 2013

Authors and Affiliations

  • H. Dong
    • 2
  • L. Xie
    • 5
  • C. Tang
    • 7
  • S. Chen
    • 6
  • Q. Liu
    • 2
  • Q. Zhang
    • 3
  • W. Zheng
    • 4
  • Z. Zheng
    • 8
  • H. Zhang
    • 1
  1. 1.Department of Integrative Oncology, Tumor Tissue Bank, Affiliated Cancer Hospital of Shantou University Medical CollegeCancer Research Center, Shantou University Medical CollegeShantouChina
  2. 2.Cancer Research CenterShantou University Medical CollegeShantouChina
  3. 3.Department of Preventive MedicineShantou University Medical CollegeShantouChina
  4. 4.Graduate ProgramShantou University Medical CollegeShantouChina
  5. 5.Department of Radiation OncologyAffiliated Cancer Hospital of Shantou University Medical CollegeShantouChina
  6. 6.Department of Thoracic SurgeryAffiliated Cancer Hospital of Shantou University Medical CollegeShantouChina
  7. 7.Department of General SurgeryThe Fifth Affiliated Hospital of Sun Yat-sen UniversityZhuhaiChina
  8. 8.Department of PathologyThe Second Affiliated Hospital of Shantou University Medical CollegeShantouChina

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