Although gallbladder
carcinoma is the most common
malignancy of the extrahepatic biliary tract, patients with this disease have a very poor prognosis. Previous investigations have documented the presence of
estrogen receptors (ER) in
gallbladder cancers for possible therapeutic benefit; however, the methods used for detection were largely imprecise, which led to a wide range of results. In light of these unclear results obtained with inferior techniques, we have attempted to determine more accurately the prevalence of ER positivity in
gallbladder cancer using an improved, more specific immunohistochemical assay (IHA) for
estrogen receptors. The IHA, which used a
pronase pretreatment and the H222
monoclonal antibody, was performed on archival
tumor specimens of 25 patients. There were no strongly or moderately positive specimens. Three specimens stained weakly positive, and 22 specimens (88%) were negative. The three specimens that were weakly positive showed neither statistical significance nor any identifiable trends with respect to patient sex,
tumor stage, or histologic type. We conclude that, contrary to previous reports, weak
estrogen receptor staining occurs in a very small percentage of gallbladder
carcinomas. Furthermore, although the minimum concentration of ER required for potential therapeutic benefit is unclear, the addition of hormonal
therapy in patients with
gallbladder cancer is not likely to alter the outcome of this
malignancy.