Expression Of P53Upregulated Modulator Of Apoptosis(PUMA) And C-myb In Gallbladder Adenocarcinoma And Their Pathological Significance

Objective:An increasing number studies have shown that PUMA and C-myb signaling pathways are involved in various human cancers including colon carcinomas and hepatocellular carcinoma.However, few studies have examined gallbladder cancer specimens,and little is known about the clinical and pathological significance of PUMA and C-myb signaling changes in gallbladder adenocarcinoma. This study has investigated the expression of PUMA and C-myb in benign and malignant lesions of gallbladder and its pathological significance.Methods:Tissue specimens from108gallbladder adenocarcinoma patients,46adjacent tissues,15cases of adenomatous polyps, and35surgical specimens from chronic cholecystitis patients were routinely paraffin embedded and sectioned. PUMA and C-myb expressions were detected with EnVision immunohistochemistry.Results:Positive rates of PUMA and C-myb are significantly higher in gallbladder adenocarcinoma tissues than that in adjacent tissues, adenomatous polyps, and chronic cholecystitis (P<0.01). Gallbladder epithelial cells in PUMA and/or C-myb positive benign cases manifest moderate to severe atypical dysplasia. Positive rates of PUMA and C-myb in well differentiated tumors with maximum diameter<2cm and with no lymph node metastasis and invasion of the surrounding tissues is significantly lower than that in those poorly differentiated cases with maximum diameter≥2cm, lymph node metastasis, and invasion of the surrounding tissues (P<0.05and P<0.01). The postsurgical survival of patients whose tumor specimens are positive for PUMA and C-myb is significantly shorter than that of those who are negative for both markers (P<0.05and P<0.01).Conclusions:1. PUMA and C-myb is highly expressed in the gallbladder adenocarcinoma;2.Our results have demonstrated that the expressions of PUMA and C-myb in gallbladder adenocarcinoma tissues is closely related to the initiation, biological behavior, and prognosis of the tumor; PUMA and C-myb positive gallbladder tumors progress rapidly, are prone to metastasis, possess strong invasive ability, and have poor prognosis.