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目的观察宫颈癌组织Krüppel样转录因子4(KLF4)表达变化,并探讨其意义。方法选择宫颈癌标本121例份、慢性宫颈炎组织标本35例份、正常宫颈组织标本35例份。采用组织微阵列和免疫组织化学法检测以上组织中的KLF4、Ki-67,通过电话及门诊复查的方式对宫颈癌患者进行随访,记录患者无病生存期(PFS)、总生存期(OS)。采用Spearman秩相关分析宫颈癌组织中KLF4与Ki-67表达的关系;用Cox比例风险模型分析OS、PFS与KLF4阳性表达的关系。结果宫颈癌组织、慢性宫颈炎组织、正常宫颈组织中KLF4阳性表达率分别为26.44%、80.00%、91.43%,宫颈癌组织与慢性宫颈炎组织、正常宫颈组织比较,P均<0.05。宫颈癌组织中KLF4阳性表达率与Ki-67阳性表达率呈负相关(rs=-0.284,P<0.05)。宫颈癌病理分级越差,KLF4阳性表达率越低(P<0.05);宫颈癌临床分期越高,KLF4阳性表达率越低(P<0.05)。Cox比例风险模型分析发现,患者的OS、PFS与KLF4阳性表达有关(HR分别为0.682、0.521,P均<0.05)。结论宫颈癌组织中KLF4低表达,与Ki-67表达呈负相关,阳性表达率越高预后越好。
Objective To observe the expression of Krüppel-like transcription factor 4 (KLF4) in cervical cancer and to explore its significance. Methods 121 cases of cervical cancer specimens, 35 cases of chronic cervicitis tissue samples, 35 cases of normal cervical tissue samples. The tissue microarrays and immunohistochemical methods were used to detect the expression of KLF4 and Ki-67 in the above tissues. The patients with cervical cancer were followed up by phone and outpatient examination. The patients’ disease-free survival (PFS), total survival (OS) . The relationship between KLF4 and Ki-67 expression in cervical cancer tissues was analyzed by Spearman rank correlation. The relationship between OS, PFS and KLF4 positive expression was analyzed by Cox proportional hazards model. Results The positive rates of KLF4 expression in cervical cancer, chronic cervicitis and normal cervical tissue were 26.44%, 80.00% and 91.43%, respectively. There was significant difference between cervical cancer and chronic cervicitis and normal cervical tissue (all P <0.05). The positive rate of KLF4 in cervical cancer tissues was negatively correlated with the positive rate of Ki-67 (rs = -0.284, P <0.05). The worse the grade of cervical cancer, the lower the positive rate of KLF4 (P <0.05). The higher the clinical stage of cervical cancer, the lower the positive rate of KLF4 was (P <0.05). Cox proportional hazards model analysis found that patients with OS, PFS and KLF4 positive expression (HR 0.682,0.521, P <0.05 respectively). Conclusion The low expression of KLF4 in cervical cancer tissue is negatively correlated with the expression of Ki-67. The higher the positive expression rate, the better the prognosis.