Fig. 4.

RILDs correlate with high TLR4 expression, but not with HBV reactivation, in human. a IHC- and HE-stained tissue microarrays of 28 liver cancer patients. Magnification ×100 and ×400. Compared with patients (such as Pt 18) with high HBsAg (arrows) and low TLR4 expression, patients (such as Pt 10) with high TLR4 expression (arrows) may develop more serious RILDs, such as liver piecemeal necrosis, inflammation, or hepatic veno-occlusive, and sinusoidal obstruction syndrome (arrows). b Grouping of RILD scores by TLR4 or HBsAg expression levels. c Grouping of RILD scores by HBV infection or reactivation. Although differences of RILDs were not observed between patients with or without HBV infection, or between patients with low versus high liver HBsAg expression, it is clear that patients with high TLR4 expression or without HBV reactivation post-RT may develop more serious RILDs. Abbreviations: RILD radiation-induced liver disease, TLR4 toll-like receptor 4, IHC immunohistochemistry, HE hematoxylin and eosin, HBV Hepatitis B virus, HBsAg hepatitis B surface antigen; Pt 10 or Pt 18, correspond to patient numbers 10 or 18 among the 28 patients in our study: Yes, with HBV infection or HBV reactivation; No, without HBV infection or HBV reactivation; RT radiotherapy