The Expression of CXCR4,MFAP2,and KLF4 in Differentiated Thyroid Cancer and Their Predictive Value for Prognosis
Objective:To investigate the expression of chemokine 4 receptor(CXCR4),microfibril as-sociated protein 2(MFAP2),and Krüppel like factor 4(KLF4)in differentiated thyroid cancer(DTC)and their predictive value for prognosis.Methods:A total of 113 patients with DTC admitted to our hospital from July 2019 to July 2020 were selected,and their tumor tissue and adjacent normal tissue were preserved during surgery.Protein immunoblotting was used to detect the expression levels of CXCR4,MFAP2,and KLF4 in DTC tissues and adjacent normal tissues.The relationship between the expression levels of CXCR4,MFAP2,and KLF4 and the clinical pathological characteristics of DTC was analyzed.The patients with DTC were fol-lowed up for 3 years,the overall survival was counted for 3 years,the expression levels of CXCR4,MFAP2,and KLF4 were compared between the death group and the survival group,and the predictive value of CX-CR4,MFAP2,and KLF4 on the prognosis of DTC was analyzed by using the ROC curve,and the Cox regres-sion model was used for the unifactorial and multifactorial analyses of the prognosis of DTC.Results:Com-pared with normal tissue adjacent to cancer,the expression of CXCR4 and MFAP2 proteins in DTC tissue was significantly increased((P<0.05)),while the expression of KLF4 protein was significantly decreased((P<0.05)).The protein expression of CXCR4 and MFAP2 in TNM stage Ⅲ,lymph node metastasis,and poorly differentiated tumors was significantly higher than in TNM stage Ⅰ+Ⅱ,non-lymph node metastasis,and moderately well differentiated tumors((P<0.05)).The protein expression of KLF4 in TNM stage Ⅲ,lymph node metastasis,and poorly differentiated tumors was significantly lower than in TNM stage Ⅰ+Ⅱ,non-lymph node metastasis,and moderately well differentiated tumors((P<0.05)).During a 3-year follow-up period of 113 DTC patients,8 cases were lost,and 105 cases were ultimately followed up.The expression of CXCR4 and MFAP2 proteins in the death group was significantly higher than those in the survival group(P<0.05),while the expression of KLF4 protein was significantly lower than in the survival group(P<0.05).Drawing the ROC curve,it was found that the AUC(95%CI)of CXCR4,MFAP2,and KLF4 alone or in combination to predict the prognosis of DTC were 0.692(0.562～0.823),0.729(0.590～0.869),0.766(0.622～0.910),and 0.832(0.690～0.975),respectively.The combined prediction performance was sig-nificantly better than the single detection(P<0.05).Cox regression analysis showed that lymph node metasta-sis,TNM stage Ⅲ,poor tumor differentiation,increased CXCR4 expression,increased MFAP2 expression,and decreased KLF4 expression were risk factors for the prognosis of DTC(P<0.05).Conclusion:CXCR4 and MFAP2 are highly expressed in tumor tissue of differentiated thyroid cancer patients,while KLF4 is low in expression.Their expression levels are related to lymph node metastasis,tumor differentiation,TNM staging,and 3-year overall survival rate.Combined detection of the three can help predict the prognosis of differentia-ted thyroid cancer.
Chemokine 4 receptorMicrofiber associated protein 2Krüppel like factor 4Dif-ferentiated thyroid cancerExpression levelPrognosisPredictive value
万方数据
维普
