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MyD88 and TLR4 Expression in Epithelial Ovarian Cancer

  • Australian Ovarian Cancer Study Group
  • Mayo Clinic Rochester, MN
  • University of Calgary
  • Catholic University of Health and Allied Sciences
  • University of Tübingen
  • University of Melbourne
  • Pomeranian Medical University in Szczecin
  • Universidade de São Paulo
  • Heidelberg University 
  • Icahn School of Medicine at Mount Sinai
  • The University of Sydney
  • Western Sydney University
  • Hospital de la Sant Pau
  • Spanish National Cancer Research Centre (CNIO)
  • Hospital Universitario 12 de Octubre
  • Cedars-Sinai Medical Center
  • University of Texas Health Science Center at Houston
  • University of Pittsburgh
  • Stanford University
  • University of Cambridge
  • Kunming Medical College
  • Westmead Hospital
  • German Cancer Research Center
  • Queensland Institute of Medical Research
  • Cambridge University Hospitals NHS Foundation Trust
  • Danish Cancer Society
  • University of New South Wales
  • University of Hawai'i at Mānoa
  • Complejo Hospitalario Universitario de Albacete
  • Peter Maccallum Cancer Centre

Research output: Contribution to journalArticlepeer-review

33 Scopus citations

Abstract

Objective: To evaluate myeloid differentiation primary response gene 88 (MyD88) and Toll-like receptor 4 (TLR4) expression in relation to clinical features of epithelial ovarian cancer, histologic subtypes, and overall survival. Patients and Methods: We conducted centralized immunohistochemical staining, semi-quantitative scoring, and survival analysis in 5263 patients participating in the Ovarian Tumor Tissue Analysis consortium. Patients were diagnosed between January 1, 1978, and December 31, 2014, including 2865 high-grade serous ovarian carcinomas (HGSOCs), with more than 12,000 person-years of follow-up time. Tissue microarrays were stained for MyD88 and TLR4, and staining intensity was classified using a 2-tiered system for each marker (weak vs strong). Results: Expression of MyD88 and TLR4 was similar in all histotypes except clear cell ovarian cancer, which showed reduced expression compared with other histotypes (P<.001 for both). In HGSOC, strong MyD88 expression was modestly associated with shortened overall survival (hazard ratio [HR], 1.13; 95% CI, 1.01-1.26; P=.04) but was also associated with advanced stage (P<.001). The expression of TLR4 was not associated with survival. In low-grade serous ovarian cancer (LGSOC), strong expression of both MyD88 and TLR4 was associated with favorable survival (HR [95% CI], 0.49 [0.29-0.84] and 0.44 [0.21-0.89], respectively; P=.009 and P=.02, respectively). Conclusion: Results are consistent with an association between strong MyD88 staining and advanced stage and poorer survival in HGSOC and demonstrate correlation between strong MyD88 and TLR4 staining and improved survival in LGSOC, highlighting the biological differences between the 2 serous histotypes.

Original languageEnglish
Pages (from-to)307-320
Number of pages14
JournalMayo Clinic Proceedings
Volume93
Issue number3
DOIs
StatePublished - Mar 1 2018

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