Purpose: Increasing evidence indicates that the transcription factor, Sp1, regulates the expression of multiple genes involved in tumor development and progression.We have recently reported that Sp1overexpression is directly correlated with the angiogenic potential of and poor prognosis for human gastric cancer. However, the underlying mechanisms that result in Sp1overexpression remain unclear. Experimental Design:The expression of Sp1and Kru« ppel-like factor 4 (KLF4), a potential tumor suppressor gene, in gastric cancer tissue was analyzed by immunohistochemistry and Western blot analysis. Alterations of Sp1and KLF4 expression were achieved by gene transfer and verified by Northern andWestern blot analyses. Furthermore, Sp1promoter activity assay, electrophoretic mobility shift assay, and chromatin immunoprecipitation assay were done to identify the KLF4 binding sites on the Sp1promoter. Results: Mutually exclusive expression of Sp1and KLF4 was evident in gastric cancer and noncancerous tissue. Specifically, strong Sp1 expression but loss of KLF4 expression was found in cancer tissue, whereas the adjacent noncancerous tissue showed negative Sp1 expression but strong KLF4 expression. Enforced KLF4 expression repressed Sp1 expression at the promoter activity, mRNA, and protein levels. Moreover, a region within the proximal Sp1 promoter was identified to have overlapping KLF4-and Sp1-binding sites, to which KLF4 and Sp1compete for binding. Sp1positively regulated its own promoter, whereas KLF4 did the opposite. Conclusions: Our data suggests that disruption of KLF4-mediated negative regulation contributes to the molecular events of Sp1 overexpression and to the development and progression of human gastric cancer.Although the incidence of gastric cancer declined in the west from the 1940s to the 1980s, it remains a major public health problem throughout the world (1). In Asia and parts of South America in particular, it is the most common epithelial malignancy and is a leading cause of cancer-related death. In fact, gastric cancer remains the fourth most frequently diagnosed malignancy worldwide and is the cause of 12% of all cancer-related deaths annually (1). Advances in the treatment of this disease are likely to come from a fuller understanding of its biology and behavior. Although various genetic and molecular alterations have been found to be associated with the malignant transformation of gastric cancer, they may represent only the pathogenesis of this disease, and they have not been identified as a specific sequence of changes leading to gastric carcinoma (2, 3). Therefore, the role and detailed mechanisms of genetic and epigenetic changes in gastric cancer development and progression remain unclear.Sp1 is a zinc finger transcription factor that is important to the transcription of many cellular and viral genes that contain GC boxes in their promoter. Additional transcription factors that are similar to Sp1 in their structural and transcriptional properties (Sp2, Sp3, and Sp4) have been cloned, th...