Evidence map›Paper›PMID 42186690›Full record

ArticleJournal of pathology and translational medicine2026

Increased Toll-like receptor 9 expression associated with cellular proliferation and poor prognosis in pleural mesothelioma.

Ali Omar Abdelaziz, Dina Moustafa Thabit, Rehab Mohamed Kamal, Hend Moness, Rasha Fouad Ahmed, Mariana Fathy Gayyed, Fatma El Zahraa Ammar Mohamed

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Article in Journal of pathology and translational medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Ali Omar AbdelazizDepartment of Chest, Faculty of Medicine, Minia University, Minia, Egypt.
Dina Moustafa ThabitDepartment of Pathology, Faculty of Medicine, Minia University, Minia, Egypt. dina.mostafa@mu.edu.eg.
Rehab Mohamed KamalDepartment of Pathology, Faculty of Medicine, Minia University, Minia, Egypt.
Hend MonessDepartment of Clinical Pathology, Faculty of Medicine, Minia University, Minia, Egypt.
Rasha Fouad AhmedDepartment of Biochemistry, Faculty of Medicine, Minia University, Minia, Egypt.
Mariana Fathy GayyedDepartment of Pathology, Faculty of Medicine, Minia University, Minia, Egypt.
Fatma El Zahraa Ammar MohamedDepartment of Pathology, Faculty of Medicine, Minia University, Minia, Egypt.

Funding

Alexander von Humboldt Foundation
6 · The paper itself

Abstract

backgroundPleural mesothelioma is an aggressive malignancy with a poor prognosis. The epithelioid subtype is the most common and can be challenging to distinguish from metastatic lung adenocarcinoma (MLAC). The role of Toll-like receptor 9 (TLR9) in the progression of pleural mesothelioma remains unclear.

methodsA total of 30 pleural biopsy specimens were collected, comprising 10 cases of pleural epithelioid mesothelioma and 20 cases of MLAC. The mRNA expression levels of TLR9 and proliferating cell nuclear antigen (PCNA) were quantified. In addition, sixty archived formalin-fixed, paraffin-embedded tissue blocks (40 epithelioid mesothelioma and 20 MLAC) were analyzed via immunohistochemistry using an anti-TLR9 antibody in relation to various clinicopathological parameters.

resultsTLR9 expression was significantly higher in epithelioid mesothelioma cases than in MLAC cases (p < .001), with mean values of 1.54 ± 0.09 and 1.02 ± 0.08, respectively. A significant positive correlation was observed between TLR9 and PCNA expression levels specifically in the epithelioid mesothelioma cohort (p < .001, r = 0.8). Furthermore, immunohistochemical analysis confirmed that high TLR9 immunoexpression was significantly more prevalent in epithelioid mesothelioma (36/40 cases; 90%) than in MLAC (3/20 cases; 15%) (p < .001). Notably, elevated TLR9 expression was associated with a significantly shorter overall survival (p = .001).

conclusionsIn conclusion, TLR9 expression is significantly elevated in epithelioid mesothelioma compared to MLAC at both the molecular and cellular levels, and its expression correlates with increased tumor proliferation and poorer prognosis. Our data suggest that TLR9 could represent a promising diagnostic and prognostic biomarker, warranting further investigation into its potential therapeutic applicability.

Indexed as

Adenocarcinoma of lungDiagnosis, differentialImmunohistochemistryMesothelioma, malignantToll-like receptor 9

Identifiers

PMID42186690
PMCPMC13586498

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