University of Oulu

Hasnat, S.; Hujanen, R.; Nwaru, B.I.; Salo, T.; Salem, A. The Prognostic Value of Toll-Like Receptors in Head and Neck Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis. Int. J. Mol. Sci. 2020, 21, 7255.

The prognostic value of toll-like receptors in head and neck squamous cell carcinoma : a systematic review and meta-analysis

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Author: Hasnat, Shrabon1; Hujanen, Roosa1; Nwaru, Bright I.2,3;
Organizations: 1Department of Oral and Maxillofacial Diseases, Clinicum, University of Helsinki, 00014 Helsinki, Finland
2Krefting Research Centre, Institute of Medicine, University of Gothenburg, 40530 Gothenburg, Sweden
3Wallenberg Centre for Molecular and Translational Medicine, Institute of Medicine, University of Gothenburg, 40530 Gothenburg, Sweden
4Translational Immunology Research Program (TRIMM), Research Program Unit (RPU), University of Helsinki, 00014 Helsinki, Finland
5Cancer and Translational Medicine Research Unit, University of Oulu, 90220 Oulu, Finland
6Medical Research Centre, Oulu University Hospital, 90220 Oulu, Finland
7Helsinki University Hospital (HUS), 00029 Helsinki, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 2.4 MB)
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Language: English
Published: Multidisciplinary Digital Publishing Institute, 2020
Publish Date: 2021-01-27


Head and neck squamous cell carcinoma (HNSCC) is a group of tumours which exhibit low 5 year survival rates. Thus, there is an urgent need to identify biomarkers that may improve the clinical utility of patients with HNSCC. Emerging studies support a role of toll-like receptors (TLRs) in carcinogenesis. Therefore, this systematic review and meta-analysis was performed to assess the prognostic value of TLR immunoexpression in HNSCC patients. We compiled the results of thirteen studies comprising 1825 patients, of which six studies were deemed qualified for quantitative synthesis. The higher immunoexpression of TLR-1 to 5 and 9 was associated with a worsening of the clinical parameters of patients with HNSCC. Furthermore, induced levels of TLR-3, 4, 5, 7 and 9 were found to predict the patients’ survival time. The meta-analysis revealed that TLR-7 overexpression is associated with a decreased mortality risk in HNSCC patients (HR 0.51; 95%CI 0.13–0.89; I2 34.6%), while a higher expression of TLR-5 predicted shorter, but non-significant, survival outcome. In conclusion, this review suggests that TLRs may represent some prognostic value for patients with HNSCC. However, due to small sample sizes and other inherent methodological limitations, more well designed studies across different populations are still needed before TLRs can be recommended as a reliable clinical risk-stratification tool.

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Series: International journal of molecular sciences
ISSN: 1661-6596
ISSN-E: 1422-0067
ISSN-L: 1661-6596
Volume: 21
Issue: 19
Pages: 1 - 19
Article number: 7255
DOI: 10.3390/ijms21197255
Type of Publication: A2 Review article in a scientific journal
Field of Science: 3122 Cancers
Funding: This research was funded by The MD-PhD Programme, Faculty of Medicine, University of Helsinki; Emil Aaltonen Foundation; Minerva Foundation Institute for Medical Research; The Maud Kuistila Memorial Foundation; Cancer Society of Finland; K. Albin Johanssons stiftelses foundation; Sigrid Jusélius Foundation; Helsinki University Central Hospital Research Funds.
Copyright information: © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (