Tamoxifen use and gallstone formation in postmenopausal breast cancer patients in south Indian population

Gall Bladder Stones Formation in Patients with Breast Cancer on Tamoxifen Therapy in Iraqi Female

BACKGROUND: Tamoxifen has an estrogenic effect on the liver, lead to increase the danger of gallstone development. AIM: This study aimed to determine the prevalence of gall bladder stones formation during tamoxifen therapy. METHODS: A prospective casecontrol study enrolled 14 premenopausal and 36 postmenopausal females. The gall bladder condition was assessed by abdominal ultrasound using “Alpinion Portable Color Doppler E-CUBE,” in addition, clinical parameters collected as age and weight of patients. RESULTS: Approximately, 14 (28%) of women were premenopausal their age ranged from (25 to 44) years, and 36 (72%) postmenopausal females their age was between (45 and 78) years. The duration of tamoxifen therapy was (range >–72) months, with 33 control cases. All cases examined by pelvic ultrasound, only 11 (22%) showed gall bladder stones. The gall bladder stones were diagnosed, in 4 of premenopausal, whereas seven patients were postmenopausal. There is a significant relation with gall bladder stones with increase body weight during therapy. CONCLUSION: There is a significant correlation between gall bladder stones formation and tamoxifen therapy. Postmenopausal women have a higher risk of developing gall bladder stones formation.

Expression of Female Sex Hormone Receptors, Connective Tissue Growth Factor and HER2 in Gallbladder Cancer

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.

Nuclear receptors as new perspective for the management of liver diseases

Nuclear receptors (NRs) are ligand-activated transcription factors that act as sensors for a broad range of natural and synthetic ligands and regulate several key hepatic functions including bile acid homeostasis, bile secretion, lipid and glucose metabolism, as well as drug deposition. Moreover, NRs control hepatic inflammation, regeneration, fibrosis, and tumor formation. Therefore, NRs are key for understanding the pathogenesis and pathophysiology of a wide range of hepatic disorders. Finally, targeting NRs and their alterations offers exciting new perspectives for the treatment of liver diseases.