title: The expression of Foxp3 and TLR4 in cervical cancer: association with immune escape and clinical pathology.
abstract: OBJECTIVE
  To explore the expression of forkhead/winged helix transcription factor p3(Foxp3) and toll-like receptor 4(TLR4) in cervical cancer and evaluate their clinical significance.
  
  
  METHODS
  Foxp3 and TLR4 protein expression was detected in 105 cervical tissue specimens including cervical cancer, cervical intraepithelial neoplasia (CIN), and healthy control samples using immunohistochemistry. Their relationship with clinicopathologic parameters was also determined.
  
  
  RESULTS
  Foxp3 and TLR4 had high levels of expression in cervical cancer cells (91.43 and 82.86%, respectively). Foxp3 levels were significantly associated with FIGO stage (P < 0.001) and tumor size (P = 0.034), while TLR4 levels were associated with clinical FIGO stage (P = 0.033) and lymph node metastasis (P = 0.031). Their expression levels were not correlated with age, histologic type, or differentiation (all P > 0.05). These findings suggest that Foxp3 and TLR4 may be useful prognostic indicators of cervical carcinoma. In addition, there were significant positive relationships between Foxp3 and TLR4 expression (r = 0.703, P < 0.001), which shows a possible link and synergistic role of Foxp3 and TLR4 in promoting the immune escape of cervical cancer.
  
  
  CONCLUSIONS
  Foxp3 and TLR4 may be useful biomarkers for patient prognosis and cervical cancer prediction and treatment.
authors.affiliation: Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, No.36 Sanhao St, Heping District, Shenyang, 110004, Liaoning, China.
authors.forename: Huijie
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, No.36 Sanhao St, Heping District, Shenyang, 110004, Liaoning, China. zsl0909@sina.com.
authors.forename: Shulan
authors.initials: S
authors.lastname: Zhang
mesh_terms: D005260:Female; D051858:Forkhead Transcription Factors / Q000032:analysis* / Q000502:physiology; D006801:Humans; D007150:Immunohistochemistry; D010338:Pathology, Clinical; D011379:Prognosis; D051197:Toll-Like Receptor 4 / Q000032:analysis* / Q000502:physiology; D019139:Tumor Escape; D002583:Uterine Cervical Neoplasms / Q000276:immunology* / Q000473:pathology; D002578:Uterine Cervical Dysplasia / Q000276:immunology / Q000473:pathology
chemical_list: C418974:FOXP3 protein, human; D051858:Forkhead Transcription Factors; C495345:TLR4 protein, human; D051197:Toll-Like Receptor 4
keywords: Cervical cancer; Foxp3; Immune escape; Immunohistochemistry; TLR4