High expression of Krüppel‐like factor 5 is associated with poor prognosis in patients with colorectal cancer

High expression of Krüppel‐like factor 5 is associated with poor prognosis in patients with colorectal cancer:

Abstract

Krüppel‐like factor 5 plays an oncogenic role and has diverse functions in cancer cells. However, correlation between Krüppel‐like factor 5 and clinical outcome has not been demonstrated in patients with colorectal cancer and colorectal liver metastasis. Herein, we analyzed 65 patients with colorectal cancer who developed colorectal liver metastasis. Clinical effects were assessed through immunohistochemical analysis of primary colorectal cancer lesions and metastatic liver lesions. High expression of Krüppel‐like factor 5 in these tissues correlated with the presence of vascular invasion, elevated serum carbohydrate antigen 19‐9 levels, large diameters of metastatic liver tumors, and poor prognosis following surgery. Multivariate analyses revealed that high expression of Krüppel‐like factor 5 was an independent prognostic factor. Increased expression of Krüppel‐like factor 5 in both colorectal cancer primaries and colorectal liver metastasis was significantly associated with shorter overall survival time and time to surgical failure. Krüppel‐like factor 5 expression positively correlated with Ki‐67 and c‐Myc expression in colorectal cancer tissues. In vitro experiments with colon cancer cell lines demonstrated that siRNA knockdown of Krüppel‐like factor 5 inhibited cell proliferation. Western blot analyses revealed that knockdown of Krüppel‐like factor 5 expression reduced cyclin D1 and c‐Myc expression. It also impaired the stem‐cell like properties of cancer cells in tumorsphere formation assays. Furthermore, anoikis assay indicated that Krüppel‐like factor 5 contributed to anoikis resistance. High Krüppel‐like factor 5 expression is associated with poor prognosis in patients with colorectal cancer and liver metastasis by promoting cell proliferation and cancer stem cell‐like properties.