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Virchows Archiv
Published in: Virchows Archiv 4/2017

01-04-2017 | Original Article

High toll-like receptor (TLR) 9 expression is associated with better prognosis in surgically treated pancreatic cancer patients

Authors: Joni Leppänen, Olli Helminen, Heikki Huhta, Joonas H. Kauppila, Joel Isohookana, Kirsi-Maria Haapasaari, Petri Lehenkari, Juha Saarnio, Tuomo J. Karttunen

Published in: Virchows Archiv | Issue 4/2017

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Abstract

Pancreatic cancer remains one of the deadliest malignancies in the world. Inflammatory response and tumor environment are thought to play a major role in its pathogenesis. Knowledge on TLR expression and impact on patient survival in pancreatic cancer is limited. The study’s aim was to clarify the role of different TLRs in pancreatic cancer. TLR2, TLR4, and TLR9 expression was investigated in 65 surgically resected pancreatic ductal adenocarcinoma specimens by immunohistochemistry. The association between TLR expression, clinical parameters, and local inflammatory response to the tumor was assessed using chi-square test. Relation between patient survival and TLR expression was calculated with multivariable Cox regression, adjusted for age, sex, and tumor stage. We found TLR2, TLR4, and TLR9 to be expressed in pancreatic cancer. There was no association between TLR expression and tumor stage, tumor size, lymph node metastasis, or tumor necrosis. Contrary to our initial hypothesis, high cytoplasmic TLR9 expression was associated with longer patient survival, and multivariate analysis identified low TLR9 expression as an independent risk factor for cancer-specific death (HR 3.090, 95% CI 1.673–5.706). The results suggest that high TLR9 expression in pancreatic ductal adenocarcinoma indicates improved prognosis. The prognostic effect of TLR9 might be associated with bacterial exposure, but this needs further evidence.
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Metadata
Title
High toll-like receptor (TLR) 9 expression is associated with better prognosis in surgically treated pancreatic cancer patients
Authors
Joni Leppänen
Olli Helminen
Heikki Huhta
Joonas H. Kauppila
Joel Isohookana
Kirsi-Maria Haapasaari
Petri Lehenkari
Juha Saarnio
Tuomo J. Karttunen
Publication date
01-04-2017
Publisher
Springer Berlin Heidelberg
Published in
Virchows Archiv / Issue 4/2017
Print ISSN: 0945-6317
Electronic ISSN: 1432-2307
DOI
https://doi.org/10.1007/s00428-017-2087-1

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