Sun ZS, Li CL, Jing HH, Wang ZZ, Zheng LB. ELF3 emerges as a novel prognostic indicator implicated in gastric cancer progression and correlated with unfavorable clinical outcomes. World J Gastrointest Oncol 2026; 18(5): 116163 [DOI: 10.4251/wjgo.v18.i5.116163]
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May 15, 2026 (publication date) through May 14, 2026
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Publication Name
World Journal of Gastrointestinal Oncology
ISSN
1948-5204
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Sun ZS, Li CL, Jing HH, Wang ZZ, Zheng LB. ELF3 emerges as a novel prognostic indicator implicated in gastric cancer progression and correlated with unfavorable clinical outcomes. World J Gastrointest Oncol 2026; 18(5): 116163 [DOI: 10.4251/wjgo.v18.i5.116163]
Zong-Sheng Sun, Chang-Lei Li, Han-Hui Jing, Zheng-Zhao Wang, Long-Bo Zheng, The Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong Province, China
Author contributions: Sun ZS did conceptualization, formal analysis, and wrote original draft; Sun ZS, Li CL, Jing HH, and Zheng LB contributed to investigation and methodology; Li CL, Jing HH, Wang ZZ, and Zheng LB contributed to review and editing; all authors contributed to data curation, validation, and have read and agreed to the published version of the manuscript.
Institutional review board statement: The study was approved by the Ethics Committee of the Affiliated Hospital of Qingdao University.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Received: November 6, 2025 Revised: December 18, 2025 Accepted: February 9, 2026 Published online: May 15, 2026 Processing time: 191 Days and 18.8 Hours
Abstract
BACKGROUND
E74-like ETS transcription factor 3 (ELF3), a member of the ETS transcription factor family, is broadly expressed and orchestrates critical cellular processes, including proliferation, differentiation, and apoptosis. While it has been implicated in various immune-related diseases and malignancies, its specific role and clinical significance in stomach adenocarcinoma (STAD) remain poorly understood.
AIM
To elucidate the expression pattern, prognostic value, and potential immunological mechanisms of ELF3 in STAD.
METHODS
We comprehensively analyzed ELF3 expression and its prognostic implications in STAD using multiple public databases, including UALCAN, TIMER, HPA, GEPIA, and Kaplan-Meier Plotter. The correlations between ELF3 expression and immune infiltration features were investigated via the TIMER and TISIDB platforms. Furthermore, the bioinformatics findings were rigorously validated in an independent clinical cohort comprising 100 STAD patients.
RESULTS
ELF3 expression was found to be significantly upregulated in STAD tissues compared to normal controls. Clinical analysis identified ELF3 as an independent prognostic factor, with high expression levels significantly associated with poor overall survival. Moreover, elevated ELF3 expression was positively correlated with increased infiltration of immune cells and chemokines. These associations suggest that ELF3 may facilitate tumor progression by shaping an immunosuppressive tumor microenvironment.
CONCLUSION
Our findings highlight ELF3 as a promising prognostic biomarker and a potential therapeutic target for STAD. The study provides novel insights into the role of ELF3 in modulating the immune microenvironment to promote gastric cancer progression.
Core Tip: E74-like ETS transcription factor 3 (ELF3) is an epithelial transcription factor whose role in stomach adenocarcinoma (STAD) has been unclear. Integrating multi-database analyses with a 100-patient clinical cohort, we show that ELF3 is upregulated in STAD, independently predicts survival, and associates with immune-cell and chemokine infiltration. High ELF3 expression co-occurs with an immunosuppressive tumor microenvironment, suggesting a mechanism for disease progression. These findings position ELF3 as a practical prognostic biomarker and a rational therapeutic target to modulate antitumor immunity in STAD.
