ELF3 emerges as a novel prognostic indicator implicated in gastric cancer progression and correlated with unfavorable clinical outcomes

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.