Liu Hai-Xia, Li Na, Wei Li, Zhou Fu-Xing, Ma Rui, Xiao Feng, Zhang Wei, Zhang Ying, Hui Yan-Ping, Song Hui, Chen Bi-Liang
1 Department of Obstetrics and Gynecology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China.
2 Department of Radiation Oncology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China.
Tumour Biol. 2017 Jun;39(6):1010428317710225. doi: 10.1177/1010428317710225.
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.
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.
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.
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.
本研究旨在探讨Kruppel样因子4表达与局部晚期宫颈鳞状细胞癌患者放疗敏感性之间的关联。
回顾性分析117例局部晚期宫颈鳞状细胞癌患者的病历，采用免疫组织化学染色检测宫颈癌组织中Kruppel样因子4的表达。分析Kruppel样因子4表达与临床病理参数之间的关联。采用Kaplan-Meier分析和Cox回归模型分析生存时间。
对放疗耐药的患者与国际妇产科联盟晚期分期、肿瘤直径（>4 cm）和低分化等级相关。Kruppel样因子4高表达水平与放疗耐药显著相关，包括放疗无反应、局部复发和远处转移。Kruppel样因子4高表达水平也与国际妇产科联盟晚期分期和低分化等级显著相关。Kaplan-Meier分析表明，Kruppel样因子4高表达的局部晚期宫颈鳞状细胞癌患者无进展生存期和总生存期较差。单因素和多因素Cox回归模型分析表明，Kruppel样因子4高表达是局部晚期宫颈鳞状细胞癌患者放疗后预后不良的高危因素之一。
我们的结果表明，Kruppel样因子4高表达可作为预测局部晚期宫颈鳞状细胞癌放疗耐药和预后不良的新型生物标志物。
