Characterization of kallikrein-related peptidase 4 (KLK4) mRNA expression in tumor tissue of advanced high-grade serous ovarian cancer patients

PLoS One. 2019 Feb 27;14(2):e0212968. doi: 10.1371/journal.pone.0212968. eCollection 2019.

Abstract

Overexpression of several members of the kallikrein-related peptidase (KLK) family, including KLK4, has been reported in ovarian cancer tissue, consistent with the fact that elevated levels of KLK protein are often also found in serum and in effusion fluids of ovarian cancer patients. In the present study, we quantitatively analyzed KLK4 tumor tissue mRNA expression levels in a homogeneous cohort including 138 patients of advanced high-grade serous ovarian cancer (FIGO stage III/IV). Age as well as ascites fluid volume were found to be significantly associated with KLK4 mRNA expression levels. In univariate Cox regression analysis, the clinical factors residual tumor mass and ascites fluid volume represented univariate predictors for both overall survival (OS) and progression-free survival (PFS). Furthermore, elevated KLK4 mRNA expression levels were significantly linked with reduced OS (p = 0.001), but not with PFS. The results concerning the association of KLK4 mRNA expression with OS were validated in a publicly available Affymetrix-based mRNA data set from The Cancer Genome Atlas (n = 252) applying the Kaplan-Meier Plotter tool (p = 0.047). In multivariable analyses, elevated KLK4 mRNA values turned out as an additional, independent predictive marker for shortened OS (p = 0.006), whereas residual tumor mass, but not ascites fluid volume, remained an independent indicator for both OS and PFS (p < 0.001 and p = 0.002, respectively). The results of the present study, obtained in a well-defined, homogenous cohort of patients afflicted with advanced high-grade serous ovarian cancer, are in line with previous reports describing high KLK4 levels as an unfavorable marker in ovarian cancer patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cystadenocarcinoma, Serous / genetics
  • Cystadenocarcinoma, Serous / pathology*
  • Female
  • Gene Expression Regulation, Neoplastic
  • Humans
  • Kallikreins / genetics*
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Grading
  • Ovarian Neoplasms / genetics
  • Ovarian Neoplasms / pathology*
  • Prognosis
  • Survival Analysis
  • Up-Regulation*

Substances

  • Kallikreins
  • kallikrein 4

Grants and funding

The present study was supported in part by grants from the the Wilhelm Sander-Stiftung, http://wilhelm-sander-stiftung.de, grant 2016-024.1 (VM) and the Deutsche Forschungsgemeinschaft, http://www.dfg.de, grants DO 1772/1–1 (JD), BR 4733/3-1 (HB), AV 109/74-1 (ED), and MA 1236/10-1 (VM), respectively. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.