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World J Gastroenterol. May 14, 2014; 20(18): 5403-5410
Published online May 14, 2014. doi: 10.3748/wjg.v20.i18.5403
Role of epithelial-mesenchymal transition in gastric cancer initiation and progression
Zhao Peng, Chen-Xiao Wang, Er-Hu Fang, Guo-Bin Wang, Qiang Tong
Zhao Peng, Chen-Xiao Wang, Er-Hu Fang, Guo-Bin Wang, Qiang Tong, Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
Author contributions: Peng Z and Wang CX contributed equally to this paper; all the authors participated in writing, editing and reviewing of this manuscript.
Supported by National Natural Science Foundation of China, No. 81172186
Correspondence to: Qiang Tong, Professor, Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan 430022, Hubei Province, China. qiangtong@hust.edu.cn
Telephone: +86-27-85351620 Fax: +86-27-85726301
Received: October 29, 2013
Revised: January 9, 2014
Accepted: January 19, 2014
Published online: May 14, 2014
Abstract

Gastric cancer is one of the most common malignant tumors worldwide. Due to its intricate initiation and progression mechanisms, early detection and effective treatment of gastric cancer are difficult to achieve. The epithelial-mesenchymal transition (EMT) is characterized as a fundamental process that is critical for embryonic development, wound healing and fibrotic disease. Recent evidence has established that aberrant EMT activation in the human stomach is closely associated with gastric carcinogenesis and tumor progression. EMT activation endows gastric epithelial cells with increased characteristics of mesenchymal cells and reduces their epithelial features. Moreover, mesenchymal cells tend to dedifferentiate and acquire stem cell or tumorigenic phenotypes such as invasion, metastasis and apoptosis resistance as well as drug resistance during EMT progression. There are a number of molecules that indicate the stage of EMT (e.g., E-cadherin, an epithelial cell biomarker); therefore, certain transcriptional proteins, especially E-cadherin transcriptional repressors, may participate in the regulation of EMT. In addition, EMT regulation may be associated with certain epigenetic mechanisms. The aforementioned molecules can be used as early diagnostic markers for gastric cancer, and EMT regulation can provide potential targets for gastric cancer therapy. Here, we review the role of these aspects of EMT in gastric cancer initiation and development.

Keywords: Epithelial-mesenchymal transition, Gastric cancer, Tumorigenesis, Tumor progression, Cancer stem cells

Core tip: Gastric cancer is responsible for numerous deaths worldwide; therefore, investigations into its initiation and development are of great importance. Recent evidence has shown that epithelial-mesenchymal transition (EMT) plays an important role in tumorigenesis and progression. In this review, we investigate the role of EMT in gastric cancer. We discuss the role of EMT in both carcinogenesis and progression. We also summarize the regulators and signal pathways involved in EMT. A systemic understanding of the role of EMT could be helpful for the early detection and effective treatment of gastric cancer.