Prospective Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 14, 2017; 23(26): 4831-4838
Published online Jul 14, 2017. doi: 10.3748/wjg.v23.i26.4831
Divergent expression of bacterial wall sensing Toll-like receptors 2 and 4 in colorectal cancer
Karoliina Paarnio, Sara Väyrynen, Kai Klintrup, Pasi Ohtonen, Markus J Mäkinen, Jyrki Mäkelä, Tuomo J Karttunen
Karoliina Paarnio, Sara Väyrynen, Kai Klintrup, Pasi Ohtonen, Markus J Mäkinen, Jyrki Mäkelä, Tuomo J Karttunen, Oulu University Hospital and Medical Research Center Oulu, POB 21, 90029 Oulu, Finland
Karoliina Paarnio, Kai Klintrup, Pasi Ohtonen, Jyrki Mäkelä, Research Unit of Surgery, Anesthesia and Intensive Care, University of Oulu, POB 5000, 90014 Oulu, Finland
Sara Väyrynen, Markus J Mäkinen, Tuomo J Karttunen, Cancer and Translational Medicine Research Unit, University of Oulu, POB 5000, 90014 Oulu, Finland
Author contributions: Mäkelä J and Karttunen TJ contributed equally to this work; Paarnio K, Mäkelä J and Karttunen TJ designed the research; Paarnio K and Väyrynen S analyzed the tissue samples; Klintrup K recruited the patients and organized the collection of the tissue samples; Ohtonen P and Paarnio K analyzed the data; Paarnio K, Mäkinen MJ, Karttunen TJ and Mäkelä J wrote the paper.
Supported by a grant from the Mary and Georg C Ehrnrooth Foundation, Finland.
Institutional review board statement: The study was reviewed and approved by the Regional Ethical Committee of North Ostrobothnia Hospital District (58/2005, 184/2009, 60/2012).
Informed consent statement: All study participants provided informed written consent prior to study enrolment. The data is stored and handled anonymously.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Karoliina Paarnio, MD, Research Unit of Surgery, Anesthesia and Intensive Care, University of Oulu, POB 5000, 90014 Oulu, Finland. karoliina.paarnio@me.com
Telephone: +358-40-0764976 Fax: +358-08-3155318
Received: December 14, 2016
Peer-review started: December 16, 2016
First decision: February 23, 2017
Revised: March 14, 2017
Accepted: May 19, 2017
Article in press: May 19, 2017
Published online: July 14, 2017
Core Tip

Core tip: Toll-like receptor 4 (TLR4) is downregulated in colorectal cancer (CRC), suggesting a role as a tumour suppressor. Low expression of TLR4 in the invasive front marks poor prognosis and is associated with metastatic disease. The most significant finding was the association between weak TLR4 expression in the tumour front and 36.9% (P = 0.044) lower cancer-specific survival in cancer of the proximal colon as compared with strong TLR4 expression. Weak TLR4 staining in tumour front was present in 50% (11/22) of the cases with metastases and only in 17% (16/94) of those without metastases (P = 0.001). TLR2 is upregulated in CRC but not associated with prognosis.