Relativity Of TLR4 Expression In Uroepithelium Carcinoma Of Bladder

ObjectiveTo determine the expression of Toll-like receptor 4 (TLR4) in uroepithelium carcinoma of bladder (BUEC) and normal bladder mucosa (NBM) and explore the correlation between TLR4 and clinicopathologic parameters of BUEC.Methods62 BUEC specimens including male 45 cases and female 17 cases were analyzed retrospectively. Including 45 cases and female 17 cases; 5 were at GI,24 at G2 and 33 at G3 according to pathologic grading (WHO 2004&ISUP)and all were diagnosed as uroepithelium carcinoma of bladder (BUEC); Single tumor 42 case, multiplicity tumor 20 cases. Select mucous near the tumor 13 cases and normal bladder mucous (NBM) 11 cases as blank control,5 cases from Lithotomy of urinary bladder,5 cases from suprapubic transvesical prostatectomy, and 1 case from transurethral ureteroscopic resection. All the samples were measured for TLR4 by immunohistochemistry.(1) All 73 cases, performance status 0-2 stage (Zubrod-ECOG-WTO), heart, lung, hepatic and renal function of patients were normal or close to normal.(2) Analyzed the relationship between TLR4 expression in BUEC and clinicophathologic parameters, as well as the relationship between TLR4 expression and sex,age,pathological diagnose standard,size,number of BUEC patients Results(1) All the controls strongly expressed TLR4, while only 60% of G1 strongly expressed TLR4,40% of G1 and 21% of G2 and 3% of G3 had low expression of TLR4,79% of G2 and 97% of G3 almost didn't express the antigen. With the progress of tumors'grade, the positive rate of TLR4 expression decreased(P<0.05).(2) The rate of TLR4 positive expression was significantly lower in multiplicity tumors than in single tumors (10.0%vs21.4%, P<0.05). There is no correlation between sex,pathology staging,age,tumor size and TLR4 positive expression.ConclusionsThis is the first report that the expression of TLR4 decreases with the progress of tumors'grade. In patients with uroepithelium carcinoma of bladder, TLR4 expression was associated significantly with tumors'grade, and the decrease of TLR4 expression was a prognostic factor for predicting progression in patients with BUECs. The study of TLR4 expression in BUECs have supplied us an important clue for the mechanism of the tumor's occurrence and may provide us a new target for the future immunological therapy.