Loss of nuclear expression of Krüppel-like factor 4 is associated with poor prognosis in patients with oral cancer

Chih Jung Chen, Li Sung Hsu, Shu Hui Lin, Mu Kuan Chen, Hsin Kai Wang, Jeng Dong Hsu, Huei Lee, Kun Tu Yeh

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Krüppel-like factor 4 is not only involved in cell proliferation but also affects cell differentiation and extracellular matrix production via positive and negative regulation of the expression of a wide range of genes. To our knowledge, little information is available regarding the role of Krüppel-like factor 4 in oral squamous cell carcinoma. In this study, we investigated the associations between Krüppel-like factor 4 expression and clinical parameters of oral cancer using immunohistochemical assays in 215 surgical specimens. Compared with positive nuclear Krüppel-like factor 4 expression, we observed that negative nuclear Krüppel-like factor 4 expression was significantly associated with an advanced cancer stage (P = .046), a high tumor recurrence rate (P = .009), and a worse 3-year survival rate in patients with oral cancer (P = .046). Nuclear expression of Krüppel-like factor 4 was shown to have an inverse relationship with Ki67 expression (P = .046). Patients with negative nuclear expression of Krüppel-like factor 4 had significantly worse overall survival rates as defined by the log-rank test (P = .014). Patients with oral cancer with negative nuclear Krüppel-like factor 4 expression in tumor cells had poor prognoses and a 2.5-fold higher death risk. Compared with disease stage (P = .025), negative nuclear Krüppel-like factor 4 expression (P = .006) was an independent prognostic factor. Our results revealed that the loss of nuclear expression of Krüppel-like factor 4 is significantly associated with aggressive clinical manifestations and might be an adverse survival factor.

Original languageEnglish
Pages (from-to)1119-1125
Number of pages7
JournalHuman Pathology
Volume43
Issue number7
DOIs
Publication statusPublished - Jul 2012
Externally publishedYes

Keywords

  • Krüppel-like factor 4
  • Nuclear expression
  • Oral cancer
  • Overall survival

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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    Chen, C. J., Hsu, L. S., Lin, S. H., Chen, M. K., Wang, H. K., Hsu, J. D., Lee, H., & Yeh, K. T. (2012). Loss of nuclear expression of Krüppel-like factor 4 is associated with poor prognosis in patients with oral cancer. Human Pathology, 43(7), 1119-1125. https://doi.org/10.1016/j.humpath.2011.09.003