Oops, you're using an old version of your browser so some of the features on this page may not be displaying properly.

MINIMAL Requirements: Google Chrome 24+Mozilla Firefox 20+Internet Explorer 11Opera 15–18Apple Safari 7SeaMonkey 2.15-2.23

Poster Display session 2

5485 - Clinical implication of CLDN18, RhoGAP, and E-cadherin in gastric signet ring cell carcinoma


29 Sep 2019


Poster Display session 2


Tumour Site

Gastric Cancer


Hyunho Kim


Annals of Oncology (2019) 30 (suppl_5): v253-v324. 10.1093/annonc/mdz247


H. Kim1, S. Kim2, J.M. Park3, H.H. Lee4, K.Y. Song4, S. Kim5, J. Kim6, S.H. Lee7, I. Kim8

Author affiliations

  • 1 Division Of Medical Oncology, Department Of Internal Medicine, The Catholic University of Korea, Saint Vincent’s hospital, 137-701 - Seoul/KR
  • 2 Division Of Medical Oncology, Department Of Internal Medicine, St.Mary Hospital Collage of Medicine the Catholic University of Korea, 06591 - Seoul/KR
  • 3 Division Of Gastroenterology, St.Mary hospital collage of medicine the catholic university of korea, 06591 - seoul/KR
  • 4 Division Of Gastrointestinal Surgery, St.Mary hospital collage of medicine the catholic university of korea, 06591 - seoul/KR
  • 5 Asan Institute For Life Sciences, University of Ulsan College of Medicine, Asan Medical Center, 05505 - Seoul/KR
  • 6 Cancer Research Institute, St.Mary hospital collage of medicine the catholic university of korea, 06591 - seoul/KR
  • 7 Department Of Hospital Pathology, St.Mary hospital collage of medicine the catholic university of korea, 06591 - seoul/KR
  • 8 Department Of Internal Medicine, Seoul St. Mary's Hospital, 06591 - Seoul/KR


Login to get immediate access to this content.

If you do not have an ESMO account, please create one for free.

Abstract 5485


Signet ring cell carcinoma (SRCC), a subtype of gastric cancer (GC), has specific epidemiology and oncogenesis, and has poor prognosis; it still has the highest number of unmet medical needs. Cytoskeletal rearrangement and disruption of cell integrity play crucial roles in SRCC pathogenesis. Recently, many studies have been conducted on molecular alterations in SRCC; with the clarification of the clinical significance of the CLDN-ARHGAP fusion gene, a large clinical trial is underway. Herein, we examined the influence of CLDN, RhoGAP, and E-cadherin on SRCC prognosis.


We reviewed advanced 663 GC patients who received palliative chemotherapy. Of these, 135 patients (20.4%) were SRCC. Multiplexed immunofluorescence was performed on the tissue samples using antibodies against CLDN18, RhoGAP, and E-cadherin. Positivty was defined as the median value of H-score.


Overall, 85 (63%) of 135 SRCC patients, were analysed based on tissue availability. Median age at GC diagnosis was 52.5 (range 20-77) years; the female-to-male ratio was 1.2. CLDN 18 showed a strong positive correlation with E-cadherin (r = 0.705, P < 0.001). E-cadherin expression was higher in the CLDN18 positive group than in the CLDN18 negative group (mean H-score, 74.9 ± 32.3 vs. 34.0 ± 30.4, P < 0.001). RhoGAP was positively correlated with E-cadherin (r = 0.354, P = 0.002). E-cadherin expression was higher in the RhoGAP positive group than the RhoGAP negative group (mean H-score, 64.5 ± 38.7 vs. 39.1 ± 29.2, P = 0.002). Overall survival (OS) was longer in the RhoGAP-negative group than in the RhoGAP positive group (median OS, 10.8 vs 6.2 months; P = 0.014). CLDN18 and E-cadherin positivity was not associated with prognosis. However, patients with RhoGAP (-)/E-cadherin (+) showed better OS than other patients (median OS, 12.1 vs 5.6 months, P = 0.003). Multivariate analysis with Cox survival regression showed that RhoGAP was found to be an independent poor prognostic factor (p = 0.041).


The correlations among CLDN18, RhoGAP, and E-cadherin may be associated with the discohesive oncogenesis seen in SRCC. We propose that these discohesive factors may be associated with prognosis of metastatic SRCC. Further functional studies are needed to clarify the role of these molecules.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.


Has not received any funding.


All authors have declared no conflicts of interest.

This site uses cookies. Some of these cookies are essential, while others help us improve your experience by providing insights into how the site is being used.

For more detailed information on the cookies we use, please check our Privacy Policy.

Customise settings
  • Necessary cookies enable core functionality. The website cannot function properly without these cookies, and you can only disable them by changing your browser preferences.