Abstract：Objective: To explore the relationship between the expression of Prospero-related homeobox protein 1 (PROX1) and Krüppel-like factor 4 (KLF4) in breast cancer patients and their relation with disease progression and prognosis. Methods: A total of 257 patients with breast cancer admitted to our hospital from May 2019 to April 2022 were selected as the breast cancer group, and another 257 patients with benign breast lesions were selected as the benign breast lesion group. The levels of serum PROX1 and KLF4 were measured using enzyme-linked immunosorbent assay (ELISA). The levels of serum PROX1 and KLF4 were compared between the two groups, as well as among patients with different pathological characteristics of breast cancer. The relationship between the levels of serum PROX1 and KLF4 and the prognostic survival of breast cancer patients was analyzed. COX regression analysis was used to investigate the factors affecting the prognostic survival of breast cancer patients and the relationship between the levels of serum PROX1 and KLF4 and the prognostic survival of various subgroups. The restricted cubic spline (RCS) model was used to analyze the nonlinear relationship between the levels of serum PROX1 and KLF4 and the prognostic survival of breast cancer patients. Results: The serum PROX1 level in breast cancer patients was higher than that in patients with benign breast lesions, while the KLF4 level was lower than that in patients with benign breast lesions (P<0.05). The serum PROX1 and KLF4 levels in breast cancer patients showed significant differences in the differentiation degree, clinical stage, estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2 (Her-2), molecular typing, and lymph node metastasis (P<0.05). Among 257 breast cancer patients followed up for 24 months, seven were lost to follow-up, yielding a survival rate of 77.20% (193/250). The survival rate of patients with high PROX1 levels at 24 months was 65.93%, significantly lower than that of patients with low PROX1 levels at 90.43%. The survival rate of patients with high KLF4 levels at 24 months was 87.80%, significantly higher than that of patients with low KLF4 levels at 66.93% (P<0.05). Multivariate COX regression analysis showed that differentiation degree, clinical stage, lymph node metastasis, and serum PROX1 and KLF4 levels were independent factors affecting the prognosis and survival of breast cancer patients (P<0.05). Subgroup analysis indicated a significant interaction between serum PROX1 and KLF4 levels and clinical stage and lymph node metastasis in terms of prognosis and survival in breast cancer patients. In the RCS model, the serum PROX1 and KLF4 levels in breast cancer patients showed a linear relationship with the risk of death (P<0.05). Conclusion: Patients with breast cancer have elevated serum levels of PROX1 and decreased levels of KLF4, which is closely related to the progression and prognosis of breast cancer. Monitoring the levels of serum PROX1 and KLF4 in breast cancer patients may help to identify the risk of breast cancer and death in the early stage and improve the prognosis of patients.
闫沙沙, 高小丽, 栾艳超, 韩青松. 乳腺癌患者PROX1 KLF4水平及与病情进展预后的关系[J]. 河北医学, 2026, 32(2): 259-265.
YAN Shasha, GAO Xiaoli, LUAN Yanchao, et al. Levels of PROX1 and KLF4 in Breast Cancer Patients and Their Relationship with Disease Progression and Prognosis. HeBei Med, 2026, 32(2): 259-265.
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2026, Vol. 32 
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