High expression of Kruppel-like factor 4 as a predictor of poor prognosis for cervical cancer patient response to radiotherapy.

Abstract

PURPOSE:

The aim of this study was to explore the associations of Kruppel-like factor 4 expression with sensitivity to radiation therapy in locally advanced cervical squamous cell carcinoma patients.

METHODS:

The records of 117 locally advanced cervical squamous cell carcinoma patients were retrospectively reviewed, and Kruppel-like factor 4 expression in cervical carcinoma tissues was examined by immunohistochemical staining. The associations of Kruppel-like factor 4 expression with clinicopathological parameters were analyzed. Survival time was analyzed using Kaplan-Meier analysis and a Cox regression model.

RESULTS:

Patients being resistant to radiation therapy were associated with advanced International Federation of Gynecology and Obstetrics stage, tumor diameter (>4 cm), and poor differentiation grade. The high Kruppel-like factor 4 expression level was significantly related to resistance to radiation therapy, including radiation therapy non-response, local recurrence, and distant metastasis. The high Kruppel-like factor 4 expression level was also significantly related to the advanced International Federation of Gynecology and Obstetrics stage and poor differentiation grade. Kaplan-Meier analysis indicates that locally advanced cervical squamous cell carcinoma patients with high Kruppel-like factor 4 expression showed worse progression-free survival and overall survival. Univariate and multivariate Cox regression model analyses suggest that the high Kruppel-like factor 4 expression was one of the high-risk factors associated with poor prognosis in locally advanced cervical squamous cell carcinoma patients after radiation therapy.

CONCLUSION:

Our results suggest that the high Kruppel-like factor 4 expression can be used as a novel biomarker to predict radiation therapy resistance and poor prognosis for locally advanced cervical squamous cell carcinoma.

• Authors: Hai-Xia Liu, Na Li, Li Wei, Fu-Xing Zhou, Rui Ma, Feng Xiao, Wei Zhang, Ying Zhang, Yan-Ping Hui, Hui Song, Bi-Liang Chen
• Journal: Tumour biology : the journal of the International Society for Oncodevelopmental Biology and Medicine (Tumour Biol) Vol. 39 Issue 6 Pg. 1010428317710225 (Jun 2017) ISSN: 1423-0380 [Electronic] Netherlands
• PMID: 28639905 (Publication Type: Journal Article)

Chemical References

• Biomarkers, Tumor
• KLF4 protein, human
• Kruppel-Like Factor 4
• Kruppel-Like Transcription Factors

Topics

• Adult
• Aged
• Biomarkers, Tumor (biosynthesis, genetics)
• Carcinoma, Squamous Cell (genetics, pathology, radiotherapy)
• Disease-Free Survival
• Female
• Gene Expression Regulation, Neoplastic
• Humans
• Kaplan-Meier Estimate
• Kruppel-Like Factor 4
• Kruppel-Like Transcription Factors (biosynthesis, genetics)
• Lymphatic Metastasis
• Middle Aged
• Prognosis
• Uterine Cervical Neoplasms (genetics, pathology, radiotherapy)