Clinical significance of zinc finger E-box binding homeobox 1 (ZEB1) in human gastric cancer

Background and Objectives Zinc finger E-box Binding homeobox 1 (ZEB1) encodes a transcription factor and is one of the epithelialmesenchymal transition (EMT)-inducible genes that play a key role in tumor progression in various cancers. The aim of this study is to clarify the clinical significance of ZEB1 expression in gastric cancer patients. Methods One hundred thirty-four patients who underwent surgery for gastric cancer were evaluated. We analyzed ZEB1 mRNA levels by real-time reverse transcription PCR in gastric cancer tissue and adjacent normal mucosa. ZEB1 protein expression in primary cancer and in peritoneal dissemination samples was measured using immunohistochemical analysis. Results Expression of the ZEB1 gene was significantly higher in cancerous tissue than in adjacent normal mucosa. Increased ZEB1 expression was significantly associated with peritoneal dissemination, and was an independent prognostic factor. Logistic regression analysis revealed that increased ZEB1 expression was an independent risk factor for peritoneal dissemination. Immunohistochemical analysis indicated that ZEB1 was intensely expressed in both primary cancer and peritoneal dissemination samples. Conclusions ZEB1 is an independent factor for peritoneal dissemination in patients with gastric cancer, and may therefore play a key role in the progression to peritoneal dissemination in gastric cancer patients. J. Surg. Oncol. 2012; 106:280-285. (c) 2011 Wiley Periodicals, Inc.