SALL4, the missing link between stem cells, development and cancer
Open accessAbstract
There is a growing body of evidence supporting that cancer cells share many similarities with embryonic stem cells (ESCs). For example, aggressive cancers and ESCs share a common gene expression signature that includes hundreds of genes. Since ESC genes are not present in most adult tissues, they could be ideal candidate targets for cancer-specific diagnosis and treatment. This is an exciting cancer-targeting model. The major hurdle to test this model is to identify the key factors/pathway(s) within ESCs that are responsible for the cancer phenotype. SALL4 is one of few genes that can establish this link. The first publication of SALL4 is on its mutation in a human inherited disorder with multiple developmental defects. Since then, over 300 papers have been published on various aspects of this gene in stem cells, development, and cancers. This review aims to summarize our current knowledge of SALL4, including a SALL4-based approach to classify and target cancers. Many questions about this important gene still remain unanswered, specifically, on how this gene regulates cell fates at a molecular level. Understanding SALL4's molecular functions will allow development of specific targeted approaches in the future.
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SALL4 is re-expressed in a significant fraction of almost all human adult tumors.
“As a transcription factor, the uniqueness of SALL4 lies in the fact that it is expressed in embryonic cells, downregulated during development, absent in most adult tissues, and re-expressed in a significant fraction of almost all human adult tumors (Moein et al, 2022; Tatetsu et al, 2016).”
From Targeting transcription factors through an IMiD independent zinc finger domain (2025) · cites this paper as Tatetsu et al, 2016
Section 3, “SALL4 in cancers” (page not provided), reports aberrant SALL4 expression in various cancers and re-expression in a subgroup of hepatocellular carcinoma patients. It does not establish that a significant fraction of almost all human adult tumors re-express SALL4; the section also says expression is rare in epithelioid sarcomas. (LLM, conf=0.87)
Experimental — accuracy not yet measuredRe-expression of SALL4 in different cancer types was mostly associated with increased tumor cell proliferation and decreased patient survival.
“Mostly, the re-expression of SALL4 was associated with increased tumor cell proliferation and decreased patient survival.”
From Epigenetic control of melanoma cell invasiveness by the stem cell factor SALL4 (2021) · cites this paper as [26]
Section 3 reports aberrant SALL4 expression across cancers and links SALL4 expression to poor survival in MDS and poor prognosis in HCC. The References list studies associating SALL4 with cancer-cell proliferation in breast and lung cancer. The copy does not establish that both associations hold for most cancer types in which SALL4 is re-expressed. (LLM, conf=0.82)
Experimental — accuracy not yet measuredSALL4 is absent in most adult tissues.
“As a transcription factor, the uniqueness of SALL4 lies in the fact that it is expressed in embryonic cells, downregulated during development, absent in most adult tissues, and re-expressed in a significant fraction of almost all human adult tumors (Moein et al, 2022; Tatetsu et al, 2016).”
From Targeting transcription factors through an IMiD independent zinc finger domain (2025) · cites this paper as Tatetsu et al, 2016
SALL4 aberrant re-expression has been reported for an increasing number of cancer types, such as germ cell tumors, hepatocellular carcinoma, gastric cancer, and leukemia.
“its aberrant re-expression has been reported for an increasing number of cancer types, such as germ cell tumors, hepatocellular carcinoma, gastric cancer, leukemia-, and others26”
From Epigenetic control of melanoma cell invasiveness by the stem cell factor SALL4 (2021) · cites this paper as [26]
Sall4 is crucial for early embryo development, and mice without Sall4 cannot survive beyond E6.5.
“Of note, Sall4 is crucial for the early development of embryos, and mice without Sall4 cannot survive beyond E6.540–42.”
From The NuRD complex cooperates with SALL4 to orchestrate reprogramming (2023) · cites this paper as [40]
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Stem Cell Gene SALL4 Suppresses Transcription through Recruitment of DNA Methyltransferases
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High-Efficiency Stem Cell Fusion-Mediated Assay Reveals Sall4 as an Enhancer of Reprogramming
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Circulating Tumor Cells in Patients with Testicular Germ Cell Tumors
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SALL4 is a key transcription regulator in normal human hematopoiesis
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Netrin-1 regulates somatic cell reprogramming and pluripotency maintenance
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Stemness factor Sall4 is required for DNA damage response in embryonic stem cells
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A SALL4/MLL/HOXA9 pathway in murine and human myeloid leukemogenesis.
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Self-citationIVIC syndrome Is caused by a c.2607delA mutation in the SALL4 locus
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Oncofetal Gene SALL4 in Aggressive Hepatocellular Carcinoma
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SALL4 is a useful marker in the diagnostic work-up of germ cell tumors in extra-testicular locations
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Dissecting the role of SALL4, a newly identified stem cell factor, in chronic myelogenous leukemia
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Investigating the role of FGF‐2 in stem cell maintenance by global phosphoproteomics profiling
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Self-citationA cohesin–OCT4 complex mediates Sox enhancers to prime an early embryonic lineage
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Molecular analysis of gastric differentiated‐type intramucosal and submucosal cancers
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Stem cell factor SALL4, a potential prognostic marker for myelodysplastic syndromes
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Self-citationSpalt-like 4 promotes posterior neural fates via repression of pou5f3 family members in Xenopus
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Self-citationDifferential SALL 4 immunoexpression in malignant rhabdoid tumours and epithelioid sarcomas
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SALL4 is a novel therapeutic target in intrahepatic cholangiocarcinoma
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Aberrant hypomethylation of SALL4 gene in patients with myelodysplastic syndrome
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SALL 4 immunohistochemistry in non‐small‐cell lung carcinomas
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Mutational analysis of SAL-Like 4 (SALL4) in Han Chinese women with premature ovarian failure
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Synergistic cooperation of Sall4 and Cyclin D1 in transcriptional repression
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The differential expression pattern of the BMI-1, SALL4 and ABCA3 genes in myeloid leukemia
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Clinicopathologic characteristics of SALL4-immunopositive hepatocellular carcinoma
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Identification of the nuclear localization signal of SALL4B, a stem cell transcription factor
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Self-citationDemethylation and Up-Regulation of an Oncogene after Hypomethylating Therapy
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Self-citationZinc finger protein SALL4 functions through an AT-rich motif to regulate gene expression
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SALL4 promotes gastric cancer progression through activating CD44 expression
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The NuRD complex cooperates with SALL4 to orchestrate reprogramming
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“5 40 – 42 .”
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Oncofetal gene SALL4 and prognosis in cancer: A systematic review with meta-analysis
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SALL4 as a transcriptional and epigenetic regulator in normal and leukemic hematopoiesis
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SALL Proteins; Common and Antagonistic Roles in Cancer
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The Impact of Iron Chelators on the Biology of Cancer Stem Cells
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SALL4: An Intriguing Therapeutic Target in Cancer Treatment
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Self-citationEpigenetic control of melanoma cell invasiveness by the stem cell factor SALL4
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miR-16 targets SALL4 to repress the proliferation and migration of gastric cancer
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Genetic Analyses Identified a SALL4 Gene Mutation Associated with Holt–Oram Syndrome
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Expression of Fascin and SALL4 in odontogenic cysts and tumors: an immunohistochemical appraisal.
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SALL4/ABCB6 Axis Suppresses Ferroptosis in Colon Cancer by Mediating Mitophagy
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“As a transcription factor, the uniqueness of SALL4 lies in the fact that it is expressed in embryonic cells, downregulated during development, absent in most adult tissues, and re-expressed in a signi fi cant fraction of almost all human adult tumors (Moein et al, 2022; Tatetsu et al, 2016).”
Self-citationADT increases prostate cancer cell invasion via altering AR/SALL4/SOX2-OCT4 stem cell signaling
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SALL4 as a Useful Marker for the Distinction of Various Gestational Trophoblastic Disease Subtypes
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CELLoGeNe - An energy landscape framework for logical networks controlling cell decisions
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The KRAB-Zinc Finger protein ZKSCAN3 represses enhancers via embedded retrotransposonsPreprint
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Neural crest induction requires SALL4-mediated BAF recruitment to lineage specific enhancers
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Role of Transcription Factor BEND3 and Its Potential Effect on Cancer Progression
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A Clinical Guidance for the Management of Patients With Hepatoid Adenocarcinoma and A Case Series
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- Authors
- Tatetsu, H., Kong, N. R., Chong, G., Amabile, G., Tenen, D. G., & Chai, L.
- Affiliations
- Brigham and Women's Hospital (US)
- Adienne (Switzerland) (CH)
- Harvard University (US)
- Corresponding author
- Chai, Li
- Venue
- Gene
- Publisher
- Elsevier BV
- Published
- 2016-06
- Volume
- 584
- Issue
- 2
- Pages
- 111-119
- ISSN
- 0378-1119 (ISSN-L)
- PMC
- PMC4823161
- OpenAlex
- W2274155363
- Cited by
- 130
- References
- 152
- Citations by year
- 2026: 5 · 2025: 15 · 2024: 9 · 2023: 20 · 2022: 12 · 2021: 24 · 2020: 13 · 2019: 9 · 2018: 11 · 2017: 8 · 2016: 3 · 2014: 1
- FWCI
- 0.94
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Gene (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (GM089820, P01HL095489, R03CA184531)
- Ministry of Education - Singapore
- V Foundation for Cancer Research
- Leukemia and Lymphoma Society (SLP-8004-14, TRP-6482-16)
- National Research Foundation
- National Medical Research Council
- Ministry of Health -Singapore
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Pluripotent Stem Cells Research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Developmental Biology and Gene Regulation
- Health Sciences › Medicine › Oncology › Cancer Cells and Metastasis
- Keywords
- SALL4, embryonic stem cells, cancer stem cells, carcinogenesis, cancer classification, targeted cancer therapy, cell fate regulation, developmental defects, gene expression signatures
- MeSH terms
- Humans, Neoplasms, Stem Cells, Transcription Factors
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