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Dash S, Nayak M, Samantaray S, Rout N, Ranjit M. Expression Pattern of Estrogen Receptor Alpha and Progesterone Receptor in Gallbladder Carcinoma and Their Association with Clinicopathological Parameters and Overall Survival. J Gastrointest Cancer 2024:10.1007/s12029-024-01045-3. [PMID: 38762689 DOI: 10.1007/s12029-024-01045-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2024] [Indexed: 05/20/2024]
Abstract
BACKGROUND Gallbladder cancer (GBC) is a highly aggressive malignant tumor with a poor prognosis. Despite being first described two centuries ago, there are no targeted therapies available beyond conventional cytotoxic therapy. Epidemiological studies have shown that the incidence of gallbladder cancer is higher in females than males. This suggests that the gallbladder may be a female sex hormone-responsive organ, and these hormones might be involved in the pathogenesis of gallbladder cancer. Therefore, we aimed to analyze the expression of ERα and PR in GBC and correlate their expression with clinicopathological variables and overall survival. PATIENTS AND METHODS A total of 235 histopathologically diagnosed GBC cases were included in this hospital-based cross-sectional study. Clinicopathological data were collected, and the expression of ERα and PR was evaluated by immunohistochemistry. RESULTS The mean age of this study population was 55.47 ± 8.45 with range 28-87 years. Females were predominated over male with a male-to-female ratio of 1:3.5. Positive nuclear expression of the ERα and PR was found in 13 (5.5%) and eight (3.4%) cases, respectively. Apart from nuclear staining, cytoplasmic expression of ERα and PR was found in three (1.2%) and 31 (13.2%) cases, respectively. Higher percentage of positive nuclear expression of ER was found in < 50 years age (p value = 0.04), parity > 4 (p value = 0.02), advanced pT stage (T3) (p value = 0.01), lymphovascular invasion (p value = 0.02), and liver invasion (p value = 0.04) which were statistically significant. Higher percentage of PR expression was also observed in < 50 years age (p value = 0.01), and tumor associated with gallstone (p value = 0.04). There was no significant correlation between cytoplasmic expression of ER, PR, and clinicopathological variables. In multivariate analysis, there was no significant correlation between ER or PR positive expression and overall survival. CONCLUSION Although nuclear expression of ERα was significantly associated with progressive disease factors but the positive expression was found in very small percentage of GBC cases. So anti-hormone therapy might be an option in patient with ER α positive gallbladder carcinoma.
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Affiliation(s)
- Sashibhusan Dash
- Department of Pathology, Acharya Harihar Post-graduate Institute of Cancer, Cuttack, Odisha, India.
- Division of Molecular Epidemiology and Public Health, ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India.
| | - Mamita Nayak
- Department of Pathology, Acharya Harihar Post-graduate Institute of Cancer, Cuttack, Odisha, India
| | - Sagarika Samantaray
- Department of Pathology, Acharya Harihar Post-graduate Institute of Cancer, Cuttack, Odisha, India
| | - Niranjan Rout
- Acharya Harihar Post-Graduate Institute of Cancer, Cuttack, Odisha, India
| | - Manoranjan Ranjit
- Division of Molecular Epidemiology and Public Health, ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
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Hryciuk B, Pęksa R, Bieńkowski M, Szymanowski B, Radecka B, Winnik K, Żok J, Cichowska N, Iliszko M, Duchnowska R. Expression of Female Sex Hormone Receptors, Connective Tissue Growth Factor and HER2 in Gallbladder Cancer. Sci Rep 2020; 10:1871. [PMID: 32024900 PMCID: PMC7002405 DOI: 10.1038/s41598-020-58777-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 12/27/2019] [Indexed: 01/14/2023] Open
Abstract
Gallbladder cancer (GBC) is a highly malignant tumor with poorly understood etiology. An insight into phenotypic features of this malignancy may add to the knowledge of its carcinogenesis and pave the way to new therapeutic approaches. We assessed the expression of female sex hormone receptors (ERα, ERβ, PR), connective tissue growth factor (CTGF) and HER2 in GBC, and adjacent normal tissue (NT), and determined their prognostic impact. Immunohistochemical (IHC) expression of all biomarkers was performed in formalin-fixed, paraffin-embedded specimens in 60 Caucasian GBC patients (51 women and 9 men). ERβ, cytoPR and CTGF expression were found in 89%, 27%, 91% of GBC, and in 63%, 87%, 100% of NT, respectively. No ERα expression was found in GBC and NT. Strong (3+) HER2 expression by IHC or HER2 amplification was seen in five GBC (10.4%). A positive correlation was found between HER2 and CTGF and ERβ expression in GBC and matched NT. In the multivariate analysis, patient age >70 years, tumor size and ERβ expression in GBC was highly predictive for OS (p = 0.003). The correlation between HER2, CTGF and ERβ expression in GBC and NT may indicate the interaction of these pathways in physiological processes and gallbladder pathology.
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Affiliation(s)
- Beata Hryciuk
- Department of Oncology, Military Institute of Medicine, Warsaw, Poland
- Mazovian Center for Lung Diseases and Tuberculosis, Division III in Otwock, Otwock, Poland
| | - Rafał Pęksa
- Pathology Department, Medical University of Gdańsk, Gdańsk, Poland
| | | | | | - Barbara Radecka
- University of Opole, Institute of Medical Science, Opole, Poland
| | - Kamil Winnik
- Pathology Department Provincial Specialist Hospital, Słupsk, Poland
| | - Jolanta Żok
- Department of Chemotherapy, Center of Pulmonology and Chemotherapy, Szklarska Poręba, Poland
| | - Natalia Cichowska
- Department of Oncology and Radiotherapy, Medical University of Gdańsk, Gdańsk, Poland
| | - Mariola Iliszko
- Department of Biology and Medical Genetics, Medical University of Gdańsk, Gdańsk, Poland
| | - Renata Duchnowska
- Department of Oncology, Military Institute of Medicine, Warsaw, Poland.
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Zhang LQ, Zhang XD, Xu J, Wan Y, Qu K, Zhang JY, Wang ZX, Wei JC, Meng FD, Tai MH, Zhou L, Liu C. Potential therapeutic targets for the primary gallbladder carcinoma: estrogen receptors. Asian Pac J Cancer Prev 2013; 14:2185-90. [PMID: 23725110 DOI: 10.7314/apjcp.2013.14.4.2185] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Gallbladder carcinoma, the most frequent malignant neoplasm of the biliary tract system, has always been considered to feature late clinical presentation and diagnosis, limited treatment options and an extremely poor prognosis. In recent years, while the incidence of gallbladder cancer has appeared to be on the increase, the available treatment methods have not greatly improved survival of the affected patients. Thus, exploring new therapeutic targets for this devastating disease is an urgent matter at present. Epidemical studies have demonstrated that the incidence of gallbladder carcinoma exhibits a distinct gender bias, affecting females two to three times more than males, pointing to crucial roles of estrogen. It is well known that estrogen acts on target tissues by binding to estrogen receptors (ERs), which are mainly divided into three subtypes, ERα, ERβ and ERγ. ERα and ERβ appear to have overlapping but also unique even opposite biological effects. As important pathogenic mediators, ERs have been considered to relate to several kinds of tumors. In gallbladder carcinoma tissue, ERs have been shown to be positively expressed, and ERs expression levels are associated with differentiation and prognosis of this cancer. Nevertheless, the exact mechanisms of estrogen inducing growth of gallbladder carcinoma remain poorly understood. On the base of the current investigations, we deduce that estrogen participates in promotion of gallbladder carcinoma by influencing the formation of gallstones, stimulating angiogenesis, and promoting abnormal proliferation. Since ERs mediate the carcinogenic actions of estrogen in gallbladder, and therapy targeting ERs may provide new directions for gallbladder carcinoma. Therefore, it should be stressed that ERs are potential therapeutic targets for gallbladder carcinoma.
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Affiliation(s)
- Ling-Qiang Zhang
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, Shaanxi Province, China
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Hassan A, Mohammad L, Nassar A, Abd-Elazeem M, Abaza M. Immunohistochemical study of estrogen and androgen receptors in skin tags. J Microsc Ultrastruct 2013. [DOI: 10.1016/j.jmau.2013.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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L1 cell adhesion molecule as a novel independent poor prognostic factor in gallbladder carcinoma. Hum Pathol 2011; 42:1476-83. [PMID: 21496863 DOI: 10.1016/j.humpath.2011.01.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2010] [Revised: 12/30/2010] [Accepted: 01/13/2011] [Indexed: 12/16/2022]
Abstract
Gallbladder carcinoma is a lethal malignancy and is hard to cure by current treatment. Thus, identification of molecular prognostic markers to predict gallbladder carcinoma as therapeutic targets is urgently needed. Recent studies have demonstrated that L1 cell adhesion molecule is associated with the prognosis of variable malignancy. Here, we investigated L1 cell adhesion molecule expression in gallbladder carcinoma and its prognostic significance. In this study, we examined L1 cell adhesion molecule expression in tumor specimens from 69 patients with gallbladder carcinoma by immunohistochemistry and analyzed the correlation between L1 cell adhesion molecule expression and clinicopathologic factors or survival. L1 cell adhesion molecule was not expressed in the normal epithelium of the gallbladder but in 63.8% of gallbladder carcinomas, remarkably at the invasive front of the tumors. In addition, L1 cell adhesion molecule expression was significantly associated with high histologic grade, advanced pathologic T stage and clinical stage, and positive venous/lymphatic invasion. Multivariate analyses showed that L1 cell adhesion molecule expression (hazard ratio, 3.503; P = .028) and clinical stage (hazard ratio, 3.091; P = .042) were independent risk factor for disease-free survival. L1 cell adhesion molecule expression in gallbladder carcinoma was significantly correlated with tumor progression and unfavorable clinicopathologic features. L1 cell adhesion molecule expression was an independent poor prognostic factor for disease-free survival in patients with gallbladder carcinoma. Taken together, our findings suggest that L1 cell adhesion molecule expression could be used as a novel prognostic factor for patient survival and might be a potential therapeutic target in gallbladder carcinomas.
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Abstract
CONTEXT A new class of estrogen receptors was discovered in 1996 and named estrogen receptor β (ER-B); the traditional estrogen receptor, which until a little more than 10 years ago was thought of as the only estrogen receptor in existence, is now called estrogen receptor α. Estrogen receptor β has at least 5 isoforms, which may have different functions and have different tissue distribution. The significance of ER-B expression in tumors was first demonstrated in breast cancer, with several studies demonstrating that women with ER-B-positive breast cancers treated with adjuvant tamoxifen have better survival, independent of estrogen receptor α expression. Pathologists need to be more aware of this increasingly important protein, as it will soon find its way into routine clinical practice. OBJECTIVE To provide pathologists with a concise review of ER-B, with special emphasis on current and potential clinical relevance. DATA SOURCES A search of the English literature in PubMed (National Library of Medicine, Bethesda, Maryland) for articles with titles including "estrogen receptor beta," with emphasis on "immunohistochemistry." Abstracts were reviewed, and selected articles were used as the basis for writing this review, mostly based on their relevance to pathology. CONCLUSIONS Estrogen receptor β and its isoforms have wider tissue distribution, including the gastrointestinal tract, lung, and brain, than the traditional estrogen receptor, now called estrogen receptor α. Estrogen receptor β expression in breast cancer is associated with favorable outcome in women treated with adjuvant tamoxifen, even in tumors negative for estrogen receptor α. The clinical significance of ER-B expression in tumors other than breast is currently under investigation.
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Affiliation(s)
- Mamoun Younes
- Department of Pathology, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA.
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Barreto SG, Haga H, Shukla PJ. Hormones and gallbladder cancer in women. Indian J Gastroenterol 2010; 28:126-30. [PMID: 19937419 DOI: 10.1007/s12664-009-0046-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2009] [Revised: 06/05/2009] [Accepted: 06/18/2009] [Indexed: 02/04/2023]
Abstract
Epidemiological evidence suggests that the incidence of gallstone disease and gallbladder cancer is higher in women. We analyzed the literature on estrogen and progesterone receptor expression in gallbladder cancer in women. A systematic search was done using Medline, Embase, and Cochrane Central Register of Controlled Trials for the years 1983-2009. The search terms used included 'gallbladder', 'gallstone', 'oestrogen/estrogen', 'progesterone', 'cancer', 'cholelithiasis', 'hormone,' and 'motility'. Hormone receptor expression in gallbladder cancer was analyzed in 11 studies of which immunohistochemistry was used in 10 and enzyme immunoassay in one study. Sample sizes varied 141. Estrogen and/or progesterone receptor expression was detectable in gallbladder cancer tissue samples in nine studies, whereas four studies failed to confirm these findings. The data on the association of hormone receptor expression to tumor differentiation is contradictory and needs further evaluation.
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Affiliation(s)
- Savio G Barreto
- Department of General and Digestive Surgery, Flinders Medical Center, Adelaide, Australia
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Clinicopathologic and Prognostic Significance of CD24 in Gallbladder Carcinoma. Pathol Oncol Res 2010; 17:45-50. [DOI: 10.1007/s12253-010-9278-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2010] [Accepted: 05/10/2010] [Indexed: 02/02/2023]
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Breast carcinoma cells in primary tumors and effusions have different gene array profiles. JOURNAL OF ONCOLOGY 2009; 2010:969084. [PMID: 19680458 PMCID: PMC2725284 DOI: 10.1155/2010/969084] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2009] [Accepted: 06/02/2009] [Indexed: 12/24/2022]
Abstract
The detection of breast carcinoma cells in effusions is associated with rapidly fatal outcome, but these cells are poorly characterized at the molecular level. This study compared the gene array signatures of breast carcinoma cells in primary carcinomas and effusions. The genetic signature of 10 primary tumors and 10 effusions was analyzed using the Array-Ready Oligo set for the Human Genome platform. Results for selected genes were validated using PCR, Western blotting, and immunohistochemistry. Array analysis identified 255 significantly downregulated and 96 upregulated genes in the effusion samples. The majority of differentially expressed genes were part of pathways involved in focal adhesion, extracellular matrix-cell interaction, and the regulation of the actin cytoskeleton. Genes that were upregulated in effusions included KRT8, BCAR1, CLDN4, VIL2, while DCN, CLDN19, ITGA7, and ITGA5 were downregulated at this anatomic site. PCR, Western blotting, and immunohistochemistry confirmed the array findings for BCAR1, CLDN4, VIL2, and DCN. Our data show that breast carcinoma cells in primary carcinomas and effusions have different gene expression signatures, and differentially express a large number of molecules related to adhesion, motility, and metastasis. These differences may have a critical role in designing therapy and in prognostication for patients with metastatic disease localized to the serosal cavities.
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