title: Correlation of Nrf2, HO-1, and MRP3 in gallbladder cancer and their relationships to clinicopathologic features and survival.
abstract: BACKGROUND
  Gallbladder cancer (GC) is considered a relatively rare malignancy with extensively poor prognosis. To guide clinicians in selecting treatment options for GC patients, reliable markers predictive of poor clinical outcome are desirable. This study analyzed the correlation of NF-E2-related factor 2 (Nrf2), heme oxygenase-1 (HO-1), and multidrug resistance-related protein 3 (MRP3) in GC and their relationships to clinicopathologic features and survival.
  
  
  METHODS
  We immunohistochemically investigated 59 specimens of gallbladder adenocarcinoma tissues using Nrf2, HO-1, and MRP3 antibodies.
  
  
  RESULTS
  There were significant correlations between the high level of Nrf2, HO-1, and MRP3 expression and the tumor differentiation, Nevin staging, and metastasis. Significant positive correlations were found between the expression status of Nrf2 and that of HO-1 and MRP3 (r = 0.38, P = 0.008 and r = 0.59, P < 0.001, respectively). High Nrf2 expression was significantly associated with shorter overall survival times in univariate analysis (log-rank test, P < 0.001), being also identified as an independent prognostic factor in multivariate analysis (P = 0.035).
  
  
  CONCLUSIONS
  Nrf2, HO-1, and MRP3 were associated with certain clinicopathologic parameters in GC. Evaluation of Nrf2 expression may be an important factor in identifying a poor prognostic group of GC.
authors.affiliation: Department of Thoracic Oncosurgery, First Affiliated Hospital, Medical School, Xi'an Jiaotong University, Shaanxi, China. wangjshxjtu@gmail.com
authors.forename: Jiansheng
authors.initials: J
authors.lastname: Wang
authors.forename: Mingxin
authors.initials: M
authors.lastname: Zhang
authors.forename: Lingmin
authors.initials: L
authors.lastname: Zhang
authors.forename: Hui
authors.initials: H
authors.lastname: Cai
authors.forename: Suna
authors.initials: S
authors.lastname: Zhou
authors.forename: Jia
authors.initials: J
authors.lastname: Zhang
authors.forename: Yang
authors.initials: Y
authors.lastname: Wang
mesh_terms: D018435:ATP Binding Cassette Transporter, Subfamily B / Q000378:metabolism*; D000230:Adenocarcinoma / Q000378:metabolism / Q000401:mortality* / Q000601:surgery; D014408:Biomarkers, Tumor / Q000378:metabolism*; D005260:Female; D005500:Follow-Up Studies; D005706:Gallbladder Neoplasms / Q000378:metabolism / Q000401:mortality* / Q000601:surgery; D051547:Heme Oxygenase-1 / Q000378:metabolism*; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D051267:NF-E2-Related Factor 2 / Q000378:metabolism*; D011379:Prognosis; D016016:Proportional Hazards Models
chemical_list: D018435:ATP Binding Cassette Transporter, Subfamily B; D014408:Biomarkers, Tumor; D051267:NF-E2-Related Factor 2; C495635:NFE2L2 protein, human; C095122:multidrug resistance protein 3; C496541:HMOX1 protein, human; D051547:Heme Oxygenase-1