Abstract
BackgroundToll-like receptors (TLR) are a family of pattern recognition receptors that constitutes a major part of the innate immune system. The TLR4/(Myeloid differentiation factor 88 (MyD88) signaling pathway has been shown to have oncogenic effects.MethodsTo demonstrate the role of TLR4/MyD88 signaling in ovarian epithelial cancers (OECs), we examined the expression of TLR4, MyD88 and nuclear factor- κB (NF-κB) in OECs. The expression of TLR4, MyD88, and NF-κB was detected by immunohistochemistry, and the relationships between these and clinicopathologic features in 123 cases of OECs were also analyzed.ResultsThe expression of TLR4, MyD88, and NF-κB in OECs was observed in 46.3% (57/123), 36.6% (45/123) and 65% (80/123) of OEC cases, respectively. The TLR4, MyD88, and NF-κB expressions were associated with the histologic type of OECs, particularly with the clear cell type of OEC. There was no significant correlation between TLR4 or NF-κB expression and histologic grade, tumor size, mitotic count, FIGO (International Federation of Gynecology and Obstetrics) stage, disease recurrence. However, there was a significant correlation between MyD88 expression and FIGO stage, disease recurrence as well as histologic type. In univariate analysis, the expression of TLR4 and MyD88, and the coexpression of TLR4/MyD88 and TLR4/MyD88/NF-κB had a significant impact on the survival of patients with OECs. Only MyD88 expression had an independent prognostic significance in multivariate analysis.ConclusionsOur findings suggest that the TLR4/MyD88 signaling pathway is associated with the survival of patients with OECs, and that MyD88 is an independent prognostic predictor in patients with OECs. The TLR4/MyD88 signaling pathway may be a mechanism responsible for poor prognosis in patients with clear cell type of OEC.
Highlights
Toll-like receptors (TLR) are a family of pattern recognition receptors that constitutes a major part of the innate immune system
When analyzing the relationship between TLR4 expression and clinicopathological features, we found that the expression of TLR4 was not correlated with histologic grade, tumor size, mitotic count, tumor stage and tumor recurrence, but it was significantly correlated with histologic type
Myeloid differentiation factor 88 (MyD88) was expressed in the cytoplasm of the tumor cells and the positive expression of MyD88 was observed in 45 cases (36.6%) of Ovarian epithelial cancer (OEC), and it had a significant correlation with tumor stage, tumor recurrence and histologic type
Summary
Toll-like receptors (TLR) are a family of pattern recognition receptors that constitutes a major part of the innate immune system. The TLR4/(Myeloid differentiation factor 88 (MyD88) signaling pathway has been shown to have oncogenic effects. 13 types of TLRs have been identified, and are mainly expressed by immune cells and epithelial cells. TLRs have been detected in many tumor cell lines or tumors, especially epithelial-derived cancers [1]. Recent evidence has shown that functional TLRs are expressed on a wide variety of tumors [2]. Most TLRs share a common adaptor molecule, myeloid differentiation primary-response protein (MyD88), to activate nuclear factor- κB (NF-κB) and mitogen-activated protein kinases (MAP kinases) and induce expression of various inflammatory cytokine genes [4]. MyD88 has recently been shown to be crucial for tumor promotion in models of spontaneous and carcinogeninduced (azoxymethane) intestinal tumorigenesis [6,7]
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