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

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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.

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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.

Author information

Authors and Affiliations

  1. Department of Integrative Oncology, Tumor Tissue Bank, Affiliated Cancer Hospital of Shantou University Medical College, Cancer Research Center, Shantou University Medical College, 22 Xinling-Road, 515041, Shantou, China

    H. Zhang

  2. Cancer Research Center, Shantou University Medical College, Shantou, China

    H. Dong & Q. Liu

  3. Department of Preventive Medicine, Shantou University Medical College, Shantou, China

    Q. Zhang

  4. Graduate Program, Shantou University Medical College, Shantou, China

    W. Zheng

  5. Department of Radiation Oncology, Affiliated Cancer Hospital of Shantou University Medical College, Shantou, China

    L. Xie

  6. Department of Thoracic Surgery, Affiliated Cancer Hospital of Shantou University Medical College, Shantou, China

    S. Chen

  7. Department of General Surgery, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China

    C. Tang

  8. Department of Pathology, The Second Affiliated Hospital of Shantou University Medical College, Shantou, China

    Z. Zheng

Authors
  1. H. Dong
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  2. L. Xie
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  3. C. Tang
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  8. Z. Zheng
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  9. H. Zhang
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Corresponding author

Correspondence to H. Zhang.

Additional information

H. Dong and L. Xie contributed equally to this article.

Electronic supplementary material

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12094_2013_1149_MOESM1_ESM.pdf

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

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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Dong, H., Xie, L., Tang, C. et al. Snail1 correlates with patient outcomes in E-cadherin-preserved gastroesophageal junction adenocarcinoma. Clin Transl Oncol 16, 783–791 (2014). https://doi.org/10.1007/s12094-013-1149-3

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  • DOI: https://doi.org/10.1007/s12094-013-1149-3

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