Department of Internal Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Korea.
Department of Hospital Pathology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.
BMC Cancer. 2017 Oct 3;17(1):670. doi: 10.1186/s12885-017-3668-8.
Slug is a transcription factor that activates the epithelial-mesenchymal transition (EMT) process in cancer progression. The aim of our study was to evaluate the clinical significance of Slug expression in gastric cancer.
The expression of Slug in gastric cancer tissues of 456 patients who underwent gastrectomy was evaluated by immunohistochemistry using tissue microarrays. Slug expression level was defined by the composite score determined by multiplying the tumor staining scores for intensity and extent. The associations of Slug expression with clinicopathological characteristics and overall and recurrence-free survival were analyzed.
Patients were divided into three groups according to Slug composite score (≤4, 6, and 9). Low, mid, and high expression of Slug was observed in 104 (22.7%), 130 (28.3%), and 225 (49.0%) of cases, respectively. Overall survival and recurrence-free survival progressively increased from high to low Slug expression. In terms of lymph node metastasis, the rate of positive lymph node metastasis was 38/104 (36.5%), 79/130 (60.8%), and 178/225 (79.1%) in low, mid, and high Slug expression groups, respectively, displaying a tendency to increase with higher Slug expression. In a multivariate analysis adjusting for patient age, tumor size, tumor depth, and histology, high Slug expression was associated with a high rate of positive lymph node metastasis compared with low Slug expression (odds ratio 3.42; 95% confidence interval, 1.74-6.69). In a subgroup analysis of T1 cancer, patients with negative Slug expression (defined as <5% positive tumor cells or no/weak staining) showed no lymph node metastasis (0/13), whereas those with positive Slug expression showed 15.9% (17/107) lymph node metastasis, with a negative predictive value of 100%.
High expression of Slug in gastric cancer tissue was associated with lymph node metastasis and poor survival. Evaluation of Slug would be useful for discriminating patients at high risk of lymph node metastasis in early gastric cancer.
Slug 是一种转录因子，可激活癌症进展中的上皮-间充质转化 (EMT) 过程。我们研究的目的是评估 Slug 表达在胃癌中的临床意义。
使用组织微阵列通过免疫组织化学评估 456 名接受胃切除术的胃癌患者的 Slug 表达。Slug 表达水平通过肿瘤染色强度和范围的乘积确定的复合评分来定义。分析 Slug 表达与临床病理特征以及总生存和无复发生存的关系。
根据 Slug 复合评分（≤4、6 和 9）将患者分为三组。分别在 104 例（22.7%）、130 例（28.3%）和 225 例（49.0%）中观察到 Slug 低、中、高表达。总体生存和无复发生存从 Slug 高表达逐渐增加到低表达。就淋巴结转移而言，在 Slug 低、中、高表达组中，阳性淋巴结转移率分别为 38/104（36.5%）、79/130（60.8%）和 178/225（79.1%），随着 Slug 表达的升高呈上升趋势。在调整患者年龄、肿瘤大小、肿瘤深度和组织学的多变量分析中，与 Slug 低表达相比，高 Slug 表达与阳性淋巴结转移率较高相关（优势比 3.42；95%置信区间，1.74-6.69）。在 T1 期癌症的亚组分析中，阴性 Slug 表达（定义为<5%的阳性肿瘤细胞或无/弱染色）的患者没有淋巴结转移（0/13），而阳性 Slug 表达的患者有 15.9%（17/107）淋巴结转移，阴性预测值为 100%。
胃癌组织中 Slug 的高表达与淋巴结转移和不良生存相关。Slug 的评估有助于区分早期胃癌中淋巴结转移风险较高的患者。
