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Coexpression of TLR9 and VEGF-C is associated with lymphatic metastasis in prostate cancer


1 Department of Urology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
2 Department of Infertility and Sexual Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
3 Department of Pathology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China

Correspondence Address:
Jin-Ming Di,
Department of Urology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630
China
Jing Zhou,
Department of Pathology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630
China
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/aja202167

PMID: 34643549

Prostate cancer (PCa) is one of the most frequent cancers in men, and its biomolecular targets have been extensively studied. This study aimed to analyze the expression of toll-like receptor 9 (TLR9) and vascular endothelial growth factor C (VEGF-C) and the clinical value of the coexpression of TLR9 and VEGF-C in PCa. We retrospectively evaluated 55 patients with clinically localized, intermediate-risk, or high-risk PCa who underwent laparoscopic radical prostatectomy (LRP) and extended pelvic lymph node dissection (ePLND) without neoadjuvant hormonal therapy at a single institution from June 2013 to December 2016. In all 55 patients, the median number of lymph nodes (LNs) resected was 23 (range: 18–31), and a total of 1269 LNs were removed, of which 78 LNs were positive. Seventeen patients had positive LNs, with a positive rate of 30.9%. In addition, the immunohistochemical results in the above patients revealed that high TLR9 expression was correlated with higher Gleason score (GS) (P = 0.049), increased LN metastasis (P = 0.004), and more perineural invasion (PNI) (P = 0.033). Moreover, VEGF-C expression was associated with GS (P = 0.040), pathological stage (pT stage) (P = 0.022), LN metastasis (P = 0.003), and PNI (P = 0.001). Furthermore, a significant positive correlation between TLR9 and VEGF-C was found (P < 0.001), and the TLR9/VEGF-C phenotype was associated with LN metastasis (P = 0.047). Collectively, we propose that TLR9 stimulation may promote LN metastasis in PCa cells through the upregulation of VEGF-C expression, thereby affecting the prognosis of PCa patients. Therefore, these markers may serve as valuable targets for the treatment of PCa.


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    -  Zeng XZ
    -  Huang ZS
    -  Fang HP
    -  Wu JY
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