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Background   Krüppel-like factor 4 (KLF4)  is involved in many important cellular processes such as growth, development, differentiation, proliferation, and apoptosis. The purpose of this study was to determine the significance of  KLF4  in both tumors and normal tissues of patients with colorectal cancer (CRC).    Methods  Between January 2003 and June 2005, 125 patients with CRC receiving treatment at the Yonsei Cancer Center were selected. We examined the mRNA level of the  KLF4  gene in primary CRC specimens and matched normal colon tissues using real-time RT-PCR. Correlation of survival with clinicopathological parameters, including  KLF4  level, was investigated with univariate and multivariate analyses.    Results  CRC tissue had a significantly lower  KLF4  level when compared with matched normal tissues ( KLF4  in tumors: 2007 ± 1531 copies/μl,  KLF4  in normal tissues: 6586 ± 2834 copies/μl;  P  <0.0001). However, there was a correlation between the  KLF4  level in tumors and normal tissues. Patients with a high  KLF4  level in matched normal tissues were more likely than those with a low  KLF4  level to develop recurrence and had poorer overall survival ( P  = 0.005). Therefore, the  KLF4  level in the normal tissue of individuals was associated with prognosis of individuals.    Conclusions  Our data suggest that  KLF4  mRNA expression level in normal tissues and tumors may be a useful prognostic marker in patients with CRC.

High KLF4 level in normal tissue predicts poor survival in colorectal cancer patients