• Munawar Hussain Shah Nishtar Medical University Multan.
  • Rana Khalid Mahmood Nishtar Medical University Multan.
  • Afra Samad Multan Medical and Dental College Multan.
  • Muhammad Abubakre Khalid Shaikh Zayed Medical College Rahim Yar Khan.
  • Mohammad Usama Shah Shaikh Zayed Medical College Rahim Yar Khan.
  • Muhammad Sulaiman Saeed Nishtar Medical University Multan.



Immunohistochemical, Estrogen Receptors, Neoplastic, Non-Neoplastic, Gallbladder


Objectives: Purpose of study is to determine Estrogen receptor status in
inflammatory and neoplastic lesions of human gallbladder and to determine any relation of
ER status with age, sex and histological grades of gallbladder carcinoma. Study Design:
Retrospective observational study. Setting: Pathology Department Nishtar Medical College
Multan. Period: March 2016 to March 2017. Methodology: In this study total no. of 50 cases of
different gallbladder diseases were included. Out of these 50 cases 30 were of neoplastic lesions
and other 20 were of non-neoplastic inflammatory lesions of gallbladder. The gallbladders
slides of these 50 cases were randomly selected from the records of Pathology Department.
Demographic variables like age and gender were calculated and analyzed. Estrogen positivity
was the outcome variable of this study. Data was analyzed using computer software SPSS
version 23. Chi square Test was applied to check the association between different variables.
Results: In this study, 100% (n=50) diagnosed cases of human gallbladder diseases including
inflammatory and neoplastic lesions were subjected to immunohistochemical staining for ER
expression. 100% (n=20) cases of inflammatory lesions and 100% (n=30) cases of neoplastic
lesions were included, in this study. Estrogen positivity was noted in 36.7% (n=11) cases of
neoplastic lesions, while it was 25% (n=5) in inflammatory lesions cases. No association was
found between estrogen positivity in groups, (÷2=0.751, p=0.386). (Table1).Histological types
of gallbladder carcinoma was noted as adenocarcinomas (well differentiated) in 60% (n=18)
cases, adenocarcinomas (moderately differentiated) in 16.7% (n=5) cases, adenocarcinomas
(poorly differentiated) in 13.4% (n=4) cases, mucinous adenocarcinomas in 1% (n=3.3) cases,
adenosquamus carcinoma in 1% (n=3.3) cases and squamous cell carcinoma in 1% (n=3.3)
cases. (Table2).No association was found between gender (p=0.780), stratified age (p=868)
and estrogen positivity (p=0.386), after applying the chi-square. Conclusion: In this study it
was concluded that statistically no significant difference has been found between ER positivity
with age, gender and histological type of carcinoma. Presence of ER raises questions regarding
the role of estrogen in various gallbladder diseases and whether this hormone is functional or
not in neoplastic lesions is also questionable. Techniques more modified may be tried in search
of better and more reliable results. It is therefore too early to consider anti-estrogen trials in
gallbladder carcinoma until the role of these steroid binding proteins is well characterized.

Author Biographies

Munawar Hussain Shah, Nishtar Medical University Multan.

MBBS, M.Phil.
Associate Professor
Department of Pathology

Rana Khalid Mahmood, Nishtar Medical University Multan.

MBBS, M.Phil.
Assistant Professor
Department of Pathology

Afra Samad, Multan Medical and Dental College Multan.

MBBS, DCP, M.Phil.
Assistant Professor
Department of Pathology

Muhammad Abubakre Khalid, Shaikh Zayed Medical College Rahim Yar Khan.

House Officer

Mohammad Usama Shah, Shaikh Zayed Medical College Rahim Yar Khan.

MBBS Final Year Student

Muhammad Sulaiman Saeed, Nishtar Medical University Multan.

B.Sc MLT, M.Sc. Biochemistry,
M.Phil. Biochemistry
Department of Pathology,