Retrospective Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 28, 2015; 21(4): 1243-1250
Published online Jan 28, 2015. doi: 10.3748/wjg.v21.i4.1243
Prognostic implications of estrogen receptor 1 and vascular endothelial growth factor A expression in primary gallbladder carcinoma
Ling-Qiang Zhang, Xin-Sen Xu, Yong Wan, Si-Dong Song, Rui-Tao Wang, Wei Chen, Zhi-Xin Wang, Hu-Lin Chang, Ji-Chao Wei, Ya-Feng Dong, Chang Liu
Ling-Qiang Zhang, Xin-Sen Xu, Yong Wan, Si-Dong Song, Rui-Tao Wang, Wei Chen, Zhi-Xin Wang, Hu-Lin Chang, Ji-Chao Wei, Chang Liu, Department of Hepatobiliary Surgery, the First Affiliated Hospital of Medical College, Xi’an Jiaotong University, Xi’an 710061, Shaanxi Province, China
Ya-Feng Dong, Department of Obstetrics and Gynecology, University of Kansas School of Medicine, KS 66160, United States
Author contributions: Zhang LQ and Xu XS contributed equally to this work; Zhang LQ and Xu XS performed the immunohistochemistry experiments and writing of the paper; Wan Y, Song SD and Wang RT performed data collection and analysis; Chen W took part in data collection; Wang ZX performed data analysis; Chang HL and Wei JC participated in literature searches; Dong YF participated in revising of the paper; Liu C participated in the research design.
Supported by National Natural Science Foundation of China, No. 81272644 and No. 81201549.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Chang Liu, MD, PhD, Department of Hepatobiliary Surgery, the First Affiliated Hospital of Medical College, Xi’an Jiaotong University, No. 277, Yanta West Road, Xi’an 710061, Shaanxi Province, China. liuchangdoctor@163.com
Telephone: +86-29-85323900 Fax: +86-29-82654746
Received: May 26, 2014
Peer-review started: May 26, 2014
First decision: June 18, 2014
Revised: July 6, 2014
Accepted: September 5, 2014
Article in press: September 5, 2014
Published online: January 28, 2015
Processing time: 246 Days and 4.2 Hours
Abstract

AIM: To investigate the prognostic significance of estrogen receptor 1 (ER1) and vascular endothelial growth factor A (VEGF-A) expression in primary gallbladder carcinoma (GBC) to identify new prognostic markers for this malignancy.

METHODS: Using immunohistochemistry, we investigated ER1 and VEGF-A expression in 78 GBC and 78 cholelithiasis (CS) tissues. The results were correlated with clinicopathological features. Univariate and multivariate analyses were performed to evaluate the relationship between ER1 and VEGF-A expression and patients’ prognosis. Further Kaplan-Meier survival analysis was also performed.

RESULTS: ER1 and VEGF-A expression was significantly higher in GBC compared with CS (47/78 vs 28/78, P < 0.05; 51/78 vs 33/78, P < 0.05). ER1 expression was correlated with gender (P < 0.05) and VEGF-A expression was correlated with tumor differentiation in GBC patients (P < 0.05). In univariate analysis, age and tumor node metastasis (TNM) stage were factors associated with GBC prognosis (P < 0.05). Although there was no statistical difference between the expression of ER1 or VEGF-A and overall survival, the high expression of ER1 combined with VEGF-A predicted a poor prognosis for GBC patients (16.30 ± 1.87 vs 24.97 ± 2.09, log-rank P < 0.05). In multivariate analysis, combined expression of ER1 and VEGF-A and TNM stage were independent prognostic factors for GBC patients (P < 0.05).

CONCLUSION: Combined expression of ER1 and VEGF-A is a potential prognostic marker for GBC patients. Clinical detection of ER1 and VEGF-A in surgically resected GBC tissues would provide an important reference for decision-making of postoperative treatment programs.

Keywords: Gallbladder carcinoma; Estrogen receptor 1; Vascular endothelial growth factor A

Core tip: Gallbladder carcinoma (GBC) is a serious threat to public health for its poor prognosis. The authors found that estrogen receptor 1 (ER1) and vascular endothelial growth factor A (VEGF-A) expression was significantly higher in GBC than in cholelithiasis tissues, and high expression of ER1 combined with VEGF-A conferred a poor prognosis in GBC patients after surgery. Combined expression of ER1 and VEGF-A was an independent factor associated with GBC prognosis. Clinical detection of ER1 and VEGF-A may guide postoperative clinical treatment of GBC patients.