599. TOLL-LIKE RECEPTORS AND ESOPHAGEAL CANCER. DIAGNOSIS, PROGNOSIS AND THERAPY

Abstract

Abstract Esophageal cancer is the sixth leading cause of cancer related morbidity worldwide. It has to predominant subtypes, esophageal adenocarcinoma (EAC) and esophageal squamous cell carcinoma (ESCC). Despite all the advances in surgical therapy and adjuvant therapies, prognosis of esophageal cancer remains poor. EAC develops through Barrett’s esophagus (BE) and columnar dysplasia, preceded by gastro-esophageal reflux disease (GERD). Incidence of ESCC is increased with tobacco smoking and alcohol abuse. Toll-like receptors (TLRs) can act as prognostic factors and potential therapeutic targets of esophageal cancer. TLRs, an important family of pattern recognition receptors, allow immune cells to recognize pathogens, triggering inflammation. TLRs-signaling pathway activates signaling elements, regulating inflammatory response, possibly correlating to carcinogenesis. In normal esophagus, TLRs play an important role in innate immunity, recognizing molecular patterns on microorganisms and inflammatory responses produced by tissue damage. It is known that TLR3, TLR4, TLR5 and TLR are increasingly expressed from GERD to AC, with TLR4 known for being a mediator of proliferation in AC, while TRL1 and TLR4 overexpression in AC is related to poor prognosis and metastatic potential. Additionally, TLR3, TLR4 and TLR9 expression in stromal cells of ESCC has been associated with lymphatic metastasis, while TLR7 and TLR9 increased expression has also been addressed to advanced disease. Herein, we aim to present all available data regarding the relations of TLRs and EC. It seems that TLRs expression can indicate esophageal metaplasia, dysplasia, and cancer. Toll-like receptors can act as significant and valuable indications in diagnosis, prognosis and potentially can be used as therapeutic target of esophageal cancer.