title: Clinicopathological significance of SOX4 expression in primary gallbladder carcinoma.
abstract: OBJECTIVE
  SOX4, as a member of the SRY-related HMG-box (SOX) transcription factor family, has been demonstrated to be involved in tumorigenesis of many human malignancies; however, its role in primary gallbladder carcinoma (PGC) is still largely unknown. The aim of this study was to investigate SOX4 expression in PGC and its prognostic significance.
  
  
  METHODS
  From 1997 to 2006, 136 patients underwent resection for PGC. The median follow-up was 12.8 months. Immunostainings for SOX4 were performed on these archival tissues. The correlation of SOX4 expression with clinicopathological features including survival was analyzed.
  
  
  RESULTS
  SOX4 was expressed in 75.0% (102/136) of PGC but not in the normal epithelium of the gallbladder. In addition, the over-expression of SOX4 was significantly associated with low histologic grade (P = 0.02), low pathologic T stage (P = 0.02), and early clinical stage (P = 0.03). The levels of SOX4 immunostainings in PGC tissues with positive nodal metastasis were also significantly lower than those without (P = 0.01). Moreover, Kaplan-Meier curves showed that SOX4 over-expression was significantly related to better overall (P = 0.008) and disease-free survival (P = 0.01). Furthermore, multivariate analyses showed that SOX4 expression was an independent risk factor for both overall (P = 0.03, hazard ratio, 3.682) and disease-free survival (P = 0.04, hazard ratio, 2.215).
  
  
  CONCLUSIONS
  Our data indicate for the first time that the over-expression of SOX4 in PGC was significantly correlated with favorable clinicopathologic features and was an independent prognostic factor for better overall and disease-free survival in patients. Therefore, SOX4 might be an auxiliary parameter for predicting malignant behavior for PGC.
  The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1534825818694957.
authors.affiliation: Department of general surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, People's Republic of China.
authors.forename: Chengguo
authors.initials: C
authors.lastname: Wang
authors.forename: Huadong
authors.initials: H
authors.lastname: Zhao
authors.forename: Jianguo
authors.initials: J
authors.lastname: Lu
authors.forename: Jikai
authors.initials: J
authors.lastname: Yin
authors.forename: Li
authors.initials: L
authors.lastname: Zang
authors.forename: Nuan
authors.initials: N
authors.lastname: Song
authors.forename: Rui
authors.initials: R
authors.lastname: Dong
authors.forename: Tao
authors.initials: T
authors.lastname: Wu
authors.forename: Xilin
authors.initials: X
authors.lastname: Du
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis*; D018572:Disease-Free Survival; D005260:Female; D005706:Gallbladder Neoplasms / Q000378:metabolism* / Q000401:mortality / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D055751:SOXC Transcription Factors / Q000032:analysis / Q000096:biosynthesis*
chemical_list: D014408:Biomarkers, Tumor; C083431:SOX4 protein, human; D055751:SOXC Transcription Factors