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Background  Toll-like receptors (TLRs) play essential role in innate and acquired immunity, are expressed in various cell types, and are associated with altered susceptibility to many diseases, and cancers. The aim of this study was to investigate  TLR2  (-196 to-174 del ),  TLR4  (Asp299Gly and Thr399Ile) and  TLR9  (T1237C and T1486C) gene polymorphisms at risk of colorectal cancer (CRC) development and progression.    Methods  Peripheral blood was obtained from 397 patients with adjuvant (stage II/III, n = 202) and metastatic (n = 195) CRC. Moreover, blood samples from 50 healthy volunteers and 40 patients with adenomatous polyps were also included as control groups. DNA from patients and controls was analyzed using PCR and PCR-RFLP for genotyping functional polymorphism within  TLR2 ,  TLR4  and  TLR9  genotypes.    Results   TLR2– 196 to-174 del / del  genotype was detected in 76.6% of the patients and was significantly higher that the controls groups ( p <0.001).  TLR4  Asp299Gly,  TLR4  Thr399Ile,  TLR9 T1237C  and  T1486C  homozygous genotypes were detected in 70.5%, 70.5%, 61.5% and 61.5% of the patients respectively, and were also significantly higher than that in the control groups ( p <0.001). All polymorphisms detected were also significantly associated with the metastatic disease ( p <0.001) leading to shorter overall survival ( p <0.001); whereas,  TLR4  Asp299Gly and Thr399Ile polymorphisms were significantly associated with  KRAS  mutations.    Conclusions  The detection of higher frequencies of the  TLR2 ,  TLR4  and/or  TLR9  polymorphisms in CRC patients compared with the control groups highlight the role of these polymorphism in CRC development and cancer progression.

Evaluation of the detection of Toll-like receptors (TLRs) in cancer development and progression in patients with colorectal cancer