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Background Famesoid X receptor (FXR) regulates tumorigenesis,but its clinical significance in gallbladder cancer (GBC) remains unclear.This study investigated its clinical and prognostic significance in GBC patients,as well as its association with the anti-apoptotic protein,myeloid cell leukemia sequence 1 (MCL1) protein.Methods FXR and MCL1 expression in 42 primary GBC and 15 normal gallbladder tissues were analyzed by immunohistochemistry.The patients and samples were collected from Ren Ji Hospital from January 2005 to December 2010.Their association with clinicopathologic factors and prognosis,as well as the correlation between FXR and MCL1 protein expression were analyzed by statistical analyses.Results Compared with normal gallbladder tissues,FXR expression was decreased and MCL1 expression was increased in GBC,during progression of tumor node metastasis (TNM) stage.The Kaplan-Meier survival analysis showed that FXR low-expression and MCL1 over-expression were significantly associated with overall poor survival.Furthermore,multivariate analysis showed that FXR and MCL1 are both prognostic factors for GBC patients.FXR low-expression was significantly correlated with MCL1 over-expression.Conclusion FXR might be a new molecular marker to predict the prognosis of patients with GBC and a novel therapeutic target.