Journal of The Showa University Society
Online ISSN : 2188-529X
Print ISSN : 2187-719X
ISSN-L : 2187-719X
Kruppel-like factor 4 expression and clinical outcomes in patients with esophageal squamous cell carcinoma
Tetsuya KitajimaGenshu TateTasuku NagumoSakiko MiuraMayumi HonmaEisuke ShiozawaMasahiko MurakamiMasafumi TakimotoToshiko Yamochi
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2021 Volume 81 Issue 4 Pages 355-362


Kruppel-like factor 4 (KLF4) is a transcriptional factor that is widely found in various human tissues. In previous studies, the dual-purpose of KLF4 has been identified – it can function either as a tumor suppressor or as an oncogene in cancer, based on its cellular context. However, there are few reports on the relationship between KLF4 expression and esophageal squamous cell carcinoma (ESCC). In this study, we aimed to elucidate the role of KLF4 in the pathogenesis of ESCC. We included patients with ESCC who underwent subtotal esophagectomy between 2016 and 2017 at the Department of Surgery, Division of Gastroenterological Surgery, Showa University School of Medicine. We retrospectively analyzed the correlations between KLF4 or p53 expression and the patient’s clinicopathological features. In this study, 88 patients were included. The proportion of KLF4-positive cells was high in the normal esophageal mucosa tissue and low in the ESCC tissue (88.6% [78/88] vs 51.1% [43/88]), and this difference in KLF4 expression was statistically significant. In patients with lymphatic metastasis or invasive carcinoma, KLF4 expression levels were low and significantly lower than in those without lymphatic metastasis or invasive carcinoma. In contrast, there were no significant correlations between p53 expression levels and clinicopathological features. In this study, we found several correlations between the expression of KLF4 and histological grade of ESCC; a low expression of KLF4 is associated with advanced ESCC. This suggests that KLF4 acts as a tumor suppressor in ESCC.

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