title: Absent Toll-like receptor-9 expression predicts poor prognosis in renal cell carcinoma.
abstract: BACKGROUND
  Toll-like receptor 9 (TLR9) is a cellular DNA-receptor whose activation with cognate ligands triggers an immune reaction, with increased production of inflammatory cytokines. The aim of this study was to examine the expression of TLR9 in renal cell carcinoma (RCC), which is generally renowned of its immunogenic nature. We also evaluated the prognostic value of TLR9 in RCC.
  
  
  METHODS
  TLR9 expression in RCC was characterized with immunohistochemistry in a retrospective study population of 152 RCC patients who underwent renal surgery. The TLR9 staining intensity was compared with clinical parameters.
  
  
  RESULTS
  Of the studied tumours, 112 (81%) exhibited cytoplasmic TLR9 immunostaining. No association was detected between cytoplasmic TLR9 immunoexpression intensity and stage, nuclear grade, histological subtype or tumour necrosis. Cytoplasmic TLR9 immunoexpression was, however, a marker of favourable RCC specific survival both in univariate analysis and in multivariate regression model.
  
  
  CONCLUSIONS
  We conclude that TLR9 expression is an independent prognostic marker of RCC and the absence of TLR9 expression is related to poorer prognosis in RCC.
authors.affiliation: Department of Surgery, Oulu University Hospital, PO Box 21, 90029 OYS, Finland. hliikane@paju.oulu.fi
authors.forename: Hanna
authors.initials: H
authors.lastname: Ronkainen
authors.forename: Pasi
authors.initials: P
authors.lastname: Hirvikoski
authors.forename: Saila
authors.initials: S
authors.lastname: Kauppila
authors.forename: Katri S
authors.initials: KS
authors.lastname: Vuopala
authors.forename: Timo K
authors.initials: TK
authors.lastname: Paavonen
authors.forename: Katri S
authors.initials: KS
authors.lastname: Selander
authors.forename: Markku H
authors.initials: MH
authors.lastname: Vaarala
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism*; D002291:Carcinoma, Papillary / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D002292:Carcinoma, Renal Cell / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D007680:Kidney Neoplasms / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D009392:Nephrectomy; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D051217:Toll-Like Receptor 9 / Q000378:metabolism*
chemical_list: D014408:Biomarkers, Tumor; C495371:TLR9 protein, human; D051217:Toll-Like Receptor 9