The Prognostic Value of Toll-Like Receptors in Head and Neck Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis

• Published in: International journal of molecular sciences 2020-10, Vol.21 (19), p.7255
• Main Authors: Hasnat, Shrabon, Hujanen, Roosa, Nwaru, Bright I, Salo, Tuula, Salem, Abdelhakim
• Format: Article
• Language: English
• Subjects: Alcohol; Bias; biomarker; Biomarkers, Tumor - genetics; Cancer; cancers; Carcinogenesis; Carcinogens; Cell and Molecular Biology; Cell- och molekylärbiologi; Disease-Free Survival; Gene Expression Regulation, Neoplastic - genetics; Head & neck cancer; Head and neck cancer; head and neck squamous cell carcinoma; Health aspects; Human papillomavirus; Humans; Immune system; Medical prognosis; Meta-analysis; Metastasis; Patients; Population studies; Prognosis; Proteins; Review; Smoking; Squamous cell carcinoma; Squamous Cell Carcinoma of Head and Neck - epidemiology; Squamous Cell Carcinoma of Head and Neck - genetics; Survival; Survival Rate; Systematic review; Toll-Like Receptor 5 - genetics; Toll-Like Receptor 7 - genetics; Toll-like receptors; Toll-Like Receptors - classification; Toll-Like Receptors - genetics; Tongue; Tumorigenesis; Tumors
• ISSN: 1422-0067; 1661-6596; 1422-0067
• DOI: 10.3390/ijms21197255

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.