ORIGINAL RESEARCH article
Front. Oncol.
Sec. Molecular and Cellular Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1640131
The association between serum KLF-5 levels and clinicopathologic characteristics of patients with non-small cell lung cancer (NSCLC) and its predictive value for prognosis
Provisionally accepted
- Second Affiliated Hospital of Naval Medical University, Shanghai, China
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OBJECTIVE: Non-small cell lung cancer (NSCLC) is the most common lung malignancy with poor prognosis. This study investigated the association between serum Krüppel-like factor 5 (KLF5) level and clinicopathologic features of NSCLC patients and its prognostic value. METHODS: This single-center retrospective study enrolled 180 NSCLC patients and 60 healthy controls from our hospital between January 2019 and August 2021. Patients were divided into better prognosis (n=128) and poor prognosis (n=52) groups based on 3-year disease-free survival. Serum KLF5 levels were measured by ELISA. The optimal cutoff value was determined by ROC analysis (5.42 ng/ml), and patients were stratified into KLF5-low and KLF5-high groups. Spearman correlation and multivariate logistic regression analyses evaluated associations between KLF5 and clinical parameters. Kaplan-Meier and Cox regression analyses evaluated prognostic associations. In-silico immunohistochemistry data from Human Protein Atlas was analyzed. RESULTS: Serum KLF5 was significantly elevated in NSCLC patients compared to healthy controls (5.87±1.92 vs 2.34±0.86 ng/ml, P<0.001) and further elevated in poor prognosis group. KLF5-high group showed advanced TNM stage, poor differentiation, positive lymph node metastasis and distal metastasis. Serum KLF5 correlated moderately with advanced TNM stage (ρ = 0.42, P < 0.001) and other progression markers. Elevated serum KLF5 was an independent risk factor for poor prognosis (HR=1.552, 95%CI: 1.330-1.811, P<0.001). ROC analysis showed AUC=0.823 for predicting poor prognosis. Human Protein Atlas analysis revealed strong KLF5 staining in NSCLC tissues. CONCLUSION: Elevated serum KLF5 independently predicts poor prognosis in NSCLC patients, serving as a potent non-invasive biomarker. Further multi-center validation studies are warranted.
Keywords: Non-small cell lung cancer, KLF5, Clinicopathological characteristics, prognosis, Cox regression analysis, ROC
Received: 03 Jun 2025; Accepted: 26 Aug 2025.
Copyright: © 2025 Xu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Wenhui Xu, Second Affiliated Hospital of Naval Medical University, Shanghai, China
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