| Objective:To investigate the expression of Kruppel-like factor 5(KLF5)and its transcription target in breast cancer,analyze their correlation with the pathological features of breast cancer and their clinical significance in predicting breast cancer metastasis to lung.Methods:Immunohistochemistry was used to detect the expression of KLF5,tumor necrosis factor-α inducible protein 2(TNFAIP2)and β-catenin in breast cancer tissues from the primary focal of breast cancer metastasis to lung(35 cases),breast cancer tissues from the primary focal of breast cancer without lung metastasis(35 cases),benign breast tumor tissues(20 cases)and paracancerous breast tissue from the primary focal of breast cancer metastasis to lung(20 cases).Fisher exact test was used to analyze the relationship between the expression of each factor and clinicopathologic characteristics of patients with breast cancer metastasis to lung.Kaplan-Meier survival analysis model was used to analyze the correlation between the expression of each factor and 5-year distant metastasis-free survival(DMFS)and overall survival(OS)of patients with breast cancer.Univariate chisquare test and multivariate binary logistic regression model were used to analyze the predictive value of KLF5,TNFAIP2 and β-catenin for the risk of breast cancer metastasis to lung.Results:The positive expression of KLF5,TNFAIP2,β-catenin in breast cancer metastasis to lung group were significantly higher than those in breast cancer without lung metastasis group and benign breast tumor group,paracancer of the primary focal of br-east cancer metastasis to lung group,and the difference between the groups was statistically significant(Fisher’s exact test P<0.05).Spearman rank correlation analysis showed that the expression level between KLF5 and TNFAIP2(r=0.443,P=0.008),between KLF-5 and β-catenin(r=0.501,P=0.002),between TNFAIP2 and β-catenin(r=0.492,P=0.003)were correlated in the same direction in breast cancer metastasis to lung group.In t he breast cancer metastasis to lung group,the expression of KLF5,TNFAIP2 and β-ca te-nin were associated with histological grade and intravascular tumor thrombus,th-e e xpression of TNFAIP2 and β-catenin were associated with lymph node metastasis,and t-he expression of β-catenin was associated with tumor size(Fisher’s exact test P<0.05);none of the factor’s expression were associated with age,molecular subtype,ER,P R,HER-2,Ki6-7 and survival status(P>0.05).Kaplan-Meier survival analysis showe-d that,the expression of KLF5,TNFAIP2 and β-catenin were significantly associated wit h DMFS(32.4%vs 69.7%,χ2=6.465,P=0.0121;29.0%vs 66.7%,χ2=7.084,P=0.011;30.4%vs 59.6%,x2=5.371,P=0.042)and OS(83.8%vs 97.0%,x2=4.152,P=0.0416;80.6%vs 97.4%,χ2=5.539,P=0.0186;78.3%vs 95.7%,χ2=7.670,P=0.0186)of brea-st cancer pati ents.Univariate and multivariate analysis indicated that intravascular can-cer embolus(OR=4.231,95%CI=1.550-11.546,P=0.004),the expressions of KLF5(OR=4.792,95%CI=1.741-13.188,P=0.002),the expression of TNFAIP2(OR=9.785,95%CI=1.759-13.586,P=0.002),the expression of β-catenin(OR=3.368,95%CI=1.164-9.744,P=0.022)and tumor size(OR=3.852,95%CI=1.401-10.590,P=0.008)were the risk factors for breast cancer metast asis to lung;the expression of KLF5 was an independent ris-k factor for breast cancer metastasis to lung(HR=3.246,95%CI=1.197-12.046,P=0.034),the diagnostic sensitivity was 71.43%(95%CI=0.535-0.848),specificity was 65.71%(95%CI=0.477-0.803),positive pre dictive value was 67.57%(95%CI=0.501-0.814),and n-egative predictive value was 65.71%(95%CI=0.569-0.783).Conclusion:The expression of KLF5,TNFAIP2 and β-catenin in breast cancer tissues from the primary focal of breast cancer metastasis to lung increased significantly and the expression between them were correlated in the same directi on,KLF5 could be used as a molecular marker to predict the risk for breast cancer metastasis to lung. |
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