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Expression Pattern of Estrogen Receptor Alpha and Progesterone Receptor in Gallbladder Carcinoma and Their Association with Clinicopathological Parameters and Overall Survival

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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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Data Availability

No datasets were generated or analysed during the current study.

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Funding

This research received funding from ICMR in the form of ICMR-Senior Research fellowship (Fellowship no: No.3/2/2/14/2018/Online Onco Fship/NCD-III).

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Authors and Affiliations

  1. Department of Pathology, Acharya Harihar Post-graduate Institute of Cancer, Cuttack, Odisha, India

    Sashibhusan Dash, Mamita Nayak & Sagarika Samantaray

  2. Division of Molecular Epidemiology and Public Health, ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India

    Sashibhusan Dash & Manoranjan Ranjit

  3. Acharya Harihar Post-Graduate Institute of Cancer, Cuttack, Odisha, India

    Niranjan Rout

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Contributions

S.D.; Conceptualization, Lab work, writing-original draft preparation, statistical analysis. S.S. M.N. & N.R.; analysis the clinical samples, writing-review and editing. M.R.R. supervision and editing. All authors have read and approved the final manuscript.

Corresponding author

Correspondence to Sashibhusan Dash.

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Ethics Approval and Consent to Participate

This study was approved by the Institutional Ethics Committee, Acharya Harihar Post-Graduate Institute of Cancer, Cuttack, Odisha (IEC-AHRCC-066/03.07.2018). All patients provided written informed consent.

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The authors declare no competing interests.

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Dash, S., Nayak, M., Samantaray, S. et al. Expression Pattern of Estrogen Receptor Alpha and Progesterone Receptor in Gallbladder Carcinoma and Their Association with Clinicopathological Parameters and Overall Survival. J Gastrointest Canc (2024). https://doi.org/10.1007/s12029-024-01045-3

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