International Journal of Hematology and Oncology 2022, Vol 32, Num 4 Page(s): 214-221
Expression of Toll-like Receptor 4, Survivin and Caspase 3 in Ovarian Cancer

Burcu YAPAR TASKOYLU1, Yeliz ARMAN KARAKAYA2, Atike GOKCEN DEMIRAY1, Gamze GOKOZ DOGU1, Arzu YAREN1, Serkan DEGIRMENCIOGLU1, Ahmet ERGIN3, Canan KARAN1, Nail OZHAN4, Derya KILIC5, Ferda BIR2

1Pamukkale University Faculty of Medicine, Department of Medical Oncology, Denizli, TURKEY
2Pamukkale University Faculty of Medicine, Department of Pathology, Denizli, TURKEY
3Pamukkale University Faculty of Medicine, Department of Social Pediatrics, Denizli, TURKEY
4Kayseri City Hospital, Clinic of Medical Oncology, Kayseri, TURKEY
5Pamukkale University Faculty of Medicine, Department of Obstetrics and Gynecology, Denizli, TURKEY

Keywords: Toll-like receptors, Survivin, Caspase
Ovarian cancer is the most lethal gynecologic malignancy. Recent studies have shown that expression levels of toll like receptor (TLR) 4, survivin and caspase-3 in cancerous tissue may have a prognostic value in many cancer types including ovarian cancer. In the present study, we aimed to investigate the relationship between immunohistochemical expression of TLR4, survivin and caspase-3 and also to assess the effects on clinicopathological variables and survival parameters. Eighty four patients with ovarian cancer who treated between 2011 and 2019 were reviewed retrospectively. TLR4, survivin and caspase-3 levels that were obtained with immunohistochemistry from the tumor embedded in paraffin blocks. TLR4 expression was found higher in advanced stage compared to the early stage disease (p= 0.034). TLR4 positivity was inversely associated with lower caspase-3 expresion (p= 0.03) and survivin expression was closely related to capsule rupture (p= 0.037). Kaplan-Meier analysis demonstrated that stage, grade, lymphovascular invasion, and platinum sensitivity were significantly associated with progression free survival. Stage and adjuvant chemotherapy were also found to be significantly associated with overall survival. In Cox multivariate analysis, comparison according to lower versus higher TLR4 expression demonstrated that higher TLR4 expression was significantly associated with decreased overall survival (HR: 0.303; 95% CI: 0.109 to 0.847; p= 0.023). But, there was no association between survival parameters and either survivin or caspase-3 levels. As a result, TLR4 expression may have a prognostic role in ovarian cancer.