The development of cancer in man involves multiple genetic changes that often lead to dysfunction of certain signaling pathways controlling cell fate, cell growth, and cell survival or cell death. Activation of the extracellular signal-regulated kinase (ERK) 1/2 and PI3-K signaling pathways is believed to be involved in

the pathological processes of cancer development. Activation of the ERK1/2 pathway results in cell proliferation [3, 4] and leads to malignant transformation both in vitro and in vivo [5, 6], and activation of NVP-BEZ235 mw the PI3-K/AKT signaling pathway inhibits apoptosis and promotes cell survival. An increasing number of studies have shown that both ERK and PI3-K/AKT signaling pathways are over-activated in various human cancers including breast cancer, lung cancer, colorectal cancer, pancreatic cancer, malignant melanoma, hepatocellular carcinoma, and cholangiocarcinoma [6–9]. In hepatocellular carcinoma, activation of ERK1/2 indicates aggressive tumor behavior and constitutes an independent

prognostic factor. Increased p-ERK1/2 and p-AKT levels correlate with decreased overall survival [10]. Elevated p-ERK1/2 and p-AKT expressions have also been found in cholangiocarcinoma [7]. Both EKR1/2 and AKT can be activated by a number of factors including EGFR, inflammation signals mediated by cytokine receptors, mutation of oncogenes such as Ras and XL765 nmr Raf, and bile acids [8]. Since few studies have examined gallbladder cancer specimens [11], little is known about the clinical or pathological significance of ERK1/2 and PI3-K/AKT signaling changes in gallbladder adenocarcinoma. In this study, we examined the frequency of

p-ERK1/2 and PI3K expression in gallbladder adenocarcinoma specimens by means of immunohistochemistry and attempt to elucidate the clinical and pathological significance of changes in the p-ERK1/2 and PI3-K/AKT pathways in gallbladder adenocarcinoma. Methods Materials 108 gallbladder carcinoma specimens were collected from the First and Second Xiangya hospitals affiliated to Central South University, and People’s Hospital of Hunan Province, Changsha, China. Resminostat 77 (71.3%) specimens came from female patients and 31 males (28.7%). All specimens were diagnosed as adenocarcinomas, of which 9 had adenoma lesions, 29 were highly differentiated, 29 moderately differentiated, 30 poorly differentiated, and the remaining 11 were mucous adenomas (10.2%). During surgery, 59 cases (54.6%) were found to have invasion of peri-cholecystic tissues and organs, 59 cases (54.6%) demonstrated local lymph node metastases; and 58 cases (53.7%) had evidence of gallstones/cholelithiasis. The applied surgical modalities include radical resection in 34 cases (31.5%), palliative resection/operation in 48 cases (44.4%), and 26 cases (24.