Mittal Sachit, Anand Akshay, Vijayashankar Aarthi, Sonkar Abhinav Arun, Husain Nuzhat, Chandra Abhijit
King George's Medical University, Lucknow India.
RML Institute of Medical Sciences, UP Lucknow.
Gulf J Oncolog. 2019 Sep;1(31):14-20.
The proposed role of Vitamin D Receptor (VDR) in various cancers underscores the importance of vitamin D compounds as a novel therapeutic agent in the prevention of occurrence and progression of cancer. Vitamin D Receptor (VDR) expression in gallbladder cancer (GBC) has not been widely analyzed yet. In the present study, an attempt has been made to study VDR expression and the role of vitamin D supplementation during palliative chemotherapy in advanced GBC.
Expression of VDR was analyzed in benign cholecystectomy specimens (n=11), and GBC specimens (n=32). Thirty patients with advanced GBC were subjected to palliative chemotherapy. Out of them, 19 patients were supplemented with Vitamin D and 11 patients were not. Effect of vitamin D supplementation on the change in vitamin D scores and improvement in quality of life (QOL) were assessed by EORTC QLQ c30 version 3.0. and the difference in outcome between the two groups were studied.
Mean intensity, staining and immunoreactivity scores signifying VDR expression were decreased in the studied population of GBC when compared to benign disease. In palliative setting, vitamin D supplementation significantly improved the quality of life. However, the effect on disease- specific survival, although present, was not statistically significant.
VDR expression downregulation is associated with increasing malignant process. Vitamin D may act as sensitizers for tumor cell death besides downplaying potential harmful effects of palliative chemotherapy thus reducing the associated morbidity. This study assumes importance as the first clinical study reporting VDR expression in GBC tissue and the possible role of vitamin D supplementation in patients with advanced disease.
维生素D受体（VDR）在各种癌症中所起的作用表明，维生素D化合物作为预防癌症发生和发展的新型治疗剂具有重要意义。胆囊癌（GBC）中维生素D受体（VDR）的表达尚未得到广泛分析。在本研究中，我们试图研究晚期GBC姑息化疗期间VDR的表达以及补充维生素D的作用。
分析了11例良性胆囊切除术标本和32例GBC标本中VDR的表达。30例晚期GBC患者接受了姑息化疗。其中，19例患者补充了维生素D，11例患者未补充。通过欧洲癌症研究与治疗组织（EORTC）QLQ c30第3.0版评估补充维生素D对维生素D评分变化和生活质量（QOL）改善的影响，并研究两组之间的结果差异。
与良性疾病相比，在研究的GBC人群中，代表VDR表达的平均强度、染色和免疫反应性评分降低。在姑息治疗中，补充维生素D显著改善了生活质量。然而，对疾病特异性生存的影响虽然存在，但无统计学意义。
VDR表达下调与恶性进程增加有关。维生素D除了可以减轻姑息化疗的潜在有害影响从而降低相关发病率外，还可能作为肿瘤细胞死亡的敏化剂。本研究作为第一项报告GBC组织中VDR表达以及补充维生素D在晚期疾病患者中可能作用的临床研究具有重要意义。
