Background and Objective

Krüppel-like factors (KLFs) are transcription factors with the ability to mediate cross-talk with signaling pathways involved in cell proliferation control, apoptosis, migration, and differentiation. They also appear to influence steroid hormone signaling through transcriptional networks involving steroid hormone receptors and members of the nuclear receptor family of transcription factors. Our study aims to evaluate the potential prognostic role of KLF5, KLF9, and KLF11 in endometrial cancer, and their correlation with hormonal receptor status and cellular proliferation.

Materials and Methods

Retrospective observational study on cases of endometrioid endometrial adenocarcinoma collected in the period January 2000–December 2011 at the University of Udine. Formalin-fixed, paraffin-embedded tissue samples were all submitted to tissue microarray immunohistochemical study. A survival analysis was performed.

Results

One hundred forty seven patients were included in the study with a mean age at surgery of 65.6 years (±10.2). 80.3% of endometrial malignancies were classified as stage FIGO I (118/147). Radiation therapy and chemotherapy were administered in 62.3% (91/146) and 6.2% (9/145) of patients respectively. Five-year overall survival and disease-free survival resulted 85.4% (95% CI, 79.8–91.4%) and 79.4% (95% CI, 73.0–86.4%) respectively. A high Ki-67, cytoplasmatic KLF5 (HR 4.72, CI.95 1.61–13.89, p < 0.05), and nuclear KLF11 (HR 3.04, CI.95 0.99–9.36, p = 0.053) scores correlated with a shorter overall survival. In addition, a high nuclear KLF11 (HR 2.59, CI.95 1.13–5.95, p < 0.05) score correlated with a shorter disease-free survival.

Conclusions

In patients affected by endometrioid endometrial carcinoma, higher staining levels of KLF5 and KLF11 correlated with a poorer prognosis. However, further studies are required in order to better clarify the role of KLFs in the natural history of endometrial cancer.

中文翻译：

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Krüppel样因子5、9和11在子宫内膜子宫内膜样癌中的预后作用。

背景与目的

克鲁勃样因子（Krüppel-likefactor，KLFs）是转录因子，具有介导与细胞增殖控制，细胞凋亡，迁移和分化所涉及的信号通路发生串扰的能力。它们似乎还通过涉及类固醇激素受体和转录因子核受体家族成员的转录网络影响类固醇激素信号传导。我们的研究旨在评估KLF5，KLF9和KLF11在子宫内膜癌中的潜在预后作用，以及它们与激素受体状态和细胞增殖的相关性。

材料和方法

乌迪内大学在2000年1月至2011年12月期间收集的子宫内膜样子宫内膜腺癌病例的回顾性观察研究。将福尔马林固定，石蜡包埋的组织样品全部提交组织微阵列免疫组织化学研究。进行生存分析。

结果

该研究共纳入147名患者，其平均手术年龄为65.6岁（±10.2）。80.3％的子宫内膜恶性肿瘤被分类为FIGO I期（118/147）。分别有62.3％（91/146）和6.2％（9/145）的患者接受了放射疗法和化学疗法。五年总体生存率和无病生存率分别为85.4％（95％CI，79.8-91.4％）和79.4％（95％CI，73.0-86.4％）。Ki-67，细胞质KLF5（HR 4.72，CI.95 1.61–13.89，p  <0.05）和核KLF11（HR 3.04，CI.95 0.99–9.36，p  = 0.053）高分与总体生存期较短有关。此外，高核KLF11（HR 2.59，CI.95 1.13–5.95，p <0.05）评分与较短的无病生存时间相关。

结论

在受子宫内膜样异位子宫内膜癌影响的患者中，较高的KLF5和KLF11染色水平与较差的预后相关。但是，需要进行进一步的研究，以更好地阐明KLF在子宫内膜癌自然病史中的作用。