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Several members of the family of tissue kallikrein and kallikrein-related peptidases have been suggested as promising tumor biomarkers with important prognostic significance. However, only one ( KLK11 ) has already been studied in laryngeal squamous cell carcinoma (LSCC) as a potential biomarker for LSCC diagnosis and/or prognosis. Our study investigated the prognostic value of kallikrein-related peptidase-4 ( KLK4 ) mRNA expression as a molecular tissue biomarker in LSCC. For this purpose,  KLK4  mRNA expression analysis was performed in 116 cancerous and 74 paired non-cancerous laryngeal tissue specimens obtained from patients that had undergone surgical treatment for primary LSCC. A remarkable downregulation of  KLK4  mRNA expression was discovered in laryngeal tumors, compared to non-cancerous laryngeal tissue specimens.  KLK4  mRNA expression was also shown to distinguish LSCC from non-cancerous laryngeal tissues. Furthermore, low  KLK4  mRNA expression was shown to predict poor disease-free survival, independently of the histological grade and size of the malignant tumor as well as patient TNM stage. According to Kaplan-Meier survival analysis, low  KLK4  mRNA expression predicts short-term relapse even among patients with well-differentiated tumors or those at an early TNM stage. Thus,  KLK4  mRNA positivity could be regarded as a novel independent indicator of favorable prognosis for the disease-free survival of LSCC patients.

Low mRNA expression levels of kallikrein-related peptidase 4 ( KLK4 ) predict short-term relapse in patients with laryngeal squamous cell carcinoma