Evidence map›Paper›PMID 28191612›Full record

ArticleVirchows Archiv : an international journal of pathology2017

High toll-like receptor (TLR) 9 expression is associated with better prognosis in surgically treated pancreatic cancer patients.

Joni Leppänen, Olli Helminen, Heikki Huhta, Joonas H Kauppila, Joel Isohookana, Kirsi-Maria Haapasaari, Petri Lehenkari, Juha Saarnio, Tuomo J Karttunen

Abstract read
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In one paragraph

Article in Virchows Archiv : an international journal of pathology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed
1.6field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 31 citations in OpenAlex.

  1. Article
  2. TLR9: A Double-Dealing Toll-Like Receptor.ImmunoTargets and therapy · 2025
    Review
  3. Review
  4. Review
  5. Article
  6. Review
  7. Article
  8. Review
  9. Article
  10. Review
  11. Review
  12. Article
  13. Significance and Role of Pattern Recognition Receptors in Malignancy.Archivum immunologiae et therapiae experimentalis · 2019
    Review
  14. Exosomes and pancreatic diseases: status, challenges, and hopes.International journal of biological sciences · 2019
    Review
  15. Article
  16. Article
  17. Prognostic role of Toll-like receptors in cancer: a meta-analysis.Therapeutics and clinical risk management · 2018
    Article
  18. Review
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 2 countries.

Joni LeppänenDepartment of Pathology, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland. joni.leppanen@oulu.fi.ORCID http://orcid.org/0000-0002-6360-021X
Olli HelminenDepartment of Pathology, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland.
Heikki HuhtaDepartment of Pathology, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland.
Joonas H KauppilaDepartment of Pathology, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland.
Joel IsohookanaDepartment of Pathology, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland.
Kirsi-Maria HaapasaariDepartment of Pathology, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland.
Petri LehenkariDepartment of Surgery, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland.
Juha SaarnioDepartment of Surgery, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland.
Tuomo J KarttunenDepartment of Pathology, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland.
Oulu University Hospital · FIKarolinska University Hospital · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Pancreatic cancer remains one of the deadliest malignancies in the world. Inflammatory response and tumor environment are thought to play a major role in its pathogenesis. Knowledge on TLR expression and impact on patient survival in pancreatic cancer is limited. The study's aim was to clarify the role of different TLRs in pancreatic cancer. TLR2, TLR4, and TLR9 expression was investigated in 65 surgically resected pancreatic ductal adenocarcinoma specimens by immunohistochemistry. The association between TLR expression, clinical parameters, and local inflammatory response to the tumor was assessed using chi-square test. Relation between patient survival and TLR expression was calculated with multivariable Cox regression, adjusted for age, sex, and tumor stage. We found TLR2, TLR4, and TLR9 to be expressed in pancreatic cancer. There was no association between TLR expression and tumor stage, tumor size, lymph node metastasis, or tumor necrosis. Contrary to our initial hypothesis, high cytoplasmic TLR9 expression was associated with longer patient survival, and multivariate analysis identified low TLR9 expression as an independent risk factor for cancer-specific death (HR 3.090, 95% CI 1.673-5.706). The results suggest that high TLR9 expression in pancreatic ductal adenocarcinoma indicates improved prognosis. The prognostic effect of TLR9 might be associated with bacterial exposure, but this needs further evidence.

Indexed as

AdultAgedBiomarkers, TumorCarcinoma, Pancreatic DuctalFemaleHumansImmunohistochemistryKaplan-Meier EstimateMaleMiddle AgedPancreatic NeoplasmsPrognosisProportional Hazards ModelsToll-Like Receptor 9Biomarkers, TumorTLR9 protein, humanToll-Like Receptor 9Inflammatory responseInnate immunityPancreatic cancerPrognosisToll-like receptor

Identifiers

PMID28191612
OpenAlexW2587070302

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.