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Int. J. Mol. Sci. 2011, 12(8), 4953-4963; doi:10.3390/ijms12084953

Low Expression of TBX4 Predicts Poor Prognosis in Patients with Stage II Pancreatic Ductal Adenocarcinoma

1,* , 2
1 Zibo Vocational Institute, Xishou Liantong, Zibo 255314, China 2 School of Resources & Environment Engineering, Shandong University of Technology, Zhangdian Zhangzhou 12, Zibo 255049, China 3 Zibo Central Hospital, Zhangdian Gong Qingtuan 54, Zibo 255036, China
* Author to whom correspondence should be addressed.
Received: 28 June 2011 / Revised: 21 July 2011 / Accepted: 27 July 2011 / Published: 3 August 2011
(This article belongs to the Special Issue Biomarkers 2011)
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This study was designed to investigate the expression of the T-box transcription factor 4 (TBX4), a tumor biomarker that was previously identified by proteomics, in pancreatic ductal adenocarcinoma (PDAC) and evaluate its clinical utility as a potential prognostic biomarkers for PDAC. The expression of TBX4 was detected in 77 stage II PDAC tumors by immunohistochemistry, and the results were analyzed with regard to clinicopathological characteristics and overall survival. Moreover, Tbx4 promoter methylation status in primary PDAC tumors and normal adjacent pancreas tissues was measured by bisulfite sequencing. Among 77 stage II PDAC tumors, 48 cases (62.3%) expressed TBX4 at a high level. No significant correlation between TBX4 expression and other clinicopathological parameters, except tumor grade and liver metastasis recurrence, was found. The survival of patients with TBX4-high expression was significantly longer than those with TBX4-low expression (P = 0.010). In multivariate analysis, low TBX4 expression was an independent prognostic factor for overall survival in patients with stage II PDAC. TBX4 promoter methylation status was frequently observed in both PDAC and normal adjacent pancreas. We conclude that a low level of TBX4 expression suggests a worse prognosis for patients with stage II PDAC. Down-regulation of the TBX4 gene in pancreas is less likely to be regulated by DNA methylation.
Keywords: pancreatic cancer; TBX4; methylation; prognosis; survival pancreatic cancer; TBX4; methylation; prognosis; survival
This is an open access article distributed under the Creative Commons Attribution License (CC BY) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Zong, M.; Meng, M.; Li, L. Low Expression of TBX4 Predicts Poor Prognosis in Patients with Stage II Pancreatic Ductal Adenocarcinoma. Int. J. Mol. Sci. 2011, 12, 4953-4963.

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