V Baskaran1, U Vij, P Sahni, R K Tandon, S Nundy. 1. Department of Gastrointestinal Surgery & Liver Transplantation, The All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India. baskaran_vasu@hotmail.com
Abstract
BACKGROUND: Gallstone disease as well as gallbladder cancer are more common in women and female sex hormones may be involved in their etiology. AIM AND METHODS: To determine whether female sex hormones have a role in the pathogenesis, of gallbladder carcinoma and in its prognosis, we estimated, by enzyme immunoassay, the estrogen and progesterone receptors (ER and PgR) in the gallbladders of 21 patients with gallbladder cancer, 19 patients with cholelithiasis, and 6 patients who underwent incidental removal of essentially normal gallbladder as a component of wider resection. RESULTS: ER were present in the gallbladder mucosa in all the three groups in proportions which were not significantly different (9/21 in carcinoma, 4/19 in gallstones, and 1/6 normal), whereas the expression of PgR was greater in carcinomas (13/18), less in cholelithiasis (4/12), and absent in normal gallbladders. PgR expression was higher in tumors of lower stage (7/7) and lower in advanced disease stage IV tumors (6/11). PgR expression was associated with better disease stage (p=0.05) and significantly longer overall survival (median survival of 301 d vs 54 d) as well as better survival within the same stage (269 d vs 54 d for stage IV disease, p=0.011). Cox's regression analysis showed that PgR was an independent risk factor (R=0.2283, p=0.0035). CONCLUSIONS: Our findings suggest that the female sex hormones may have a role in the pathogenesis of gallbladder cancer and that PgR expression has a prognostic significance. We believe that when this relationship is reaffirmed by larger studies, gallbladder cancer may be treated with appropriate sex hormonal manipulation.
BACKGROUND:Gallstone disease as well as gallbladder cancer are more common in women and female sex hormones may be involved in their etiology. AIM AND METHODS: To determine whether female sex hormones have a role in the pathogenesis, of gallbladder carcinoma and in its prognosis, we estimated, by enzyme immunoassay, the estrogen and progesterone receptors (ER and PgR) in the gallbladders of 21 patients with gallbladder cancer, 19 patients with cholelithiasis, and 6 patients who underwent incidental removal of essentially normal gallbladder as a component of wider resection. RESULTS: ER were present in the gallbladder mucosa in all the three groups in proportions which were not significantly different (9/21 in carcinoma, 4/19 in gallstones, and 1/6 normal), whereas the expression of PgR was greater in carcinomas (13/18), less in cholelithiasis (4/12), and absent in normal gallbladders. PgR expression was higher in tumors of lower stage (7/7) and lower in advanced disease stage IV tumors (6/11). PgR expression was associated with better disease stage (p=0.05) and significantly longer overall survival (median survival of 301 d vs 54 d) as well as better survival within the same stage (269 d vs 54 d for stage IV disease, p=0.011). Cox's regression analysis showed that PgR was an independent risk factor (R=0.2283, p=0.0035). CONCLUSIONS: Our findings suggest that the female sex hormones may have a role in the pathogenesis of gallbladder cancer and that PgR expression has a prognostic significance. We believe that when this relationship is reaffirmed by larger studies, gallbladder cancer may be treated with appropriate sex hormonal manipulation.
Authors: Thomas A Sellers; Jenny Davis; James R Cerhan; Robert A Vierkant; Janet E Olson; V Shane Pankratz; John D Potter; Aaron R Folsom Journal: Am J Epidemiol Date: 2002-02-01 Impact factor: 4.897
Authors: Sarah S Jackson; Hans-Olov Adami; Gabriella Andreotti; Laura E Beane-Freeman; Amy Berrington de González; Julie E Buring; Gary E Fraser; Neal D Freedman; Susan M Gapstur; Gretchen Gierach; Graham G Giles; Francine Grodstein; Patricia Hartge; Mazda Jenab; Victoria Kirsh; Synnove F Knutsen; Qing Lan; Susanna C Larsson; I-Min Lee; Mei-Hsuan Lee; Linda M Liao; Roger L Milne; Kristine R Monroe; Marian L Neuhouser; Katie M O'Brien; Jessica L Petrick; Mark P Purdue; Thomas E Rohan; Sven Sandin; Dale P Sandler; Norie Sawada; Aladdin H Shadyab; Tracey G Simon; Rashmi Sinha; Rachael Stolzenberg-Solomon; Shoichiro Tsugane; Elisabete Weiderpass; Alicja Wolk; Hwai-I Yang; Wei Zheng; Katherine A McGlynn; Peter T Campbell; Jill Koshiol Journal: J Hepatol Date: 2020-05-11 Impact factor: 25.083