Association Between Helicobacter Pylori Infection And Primary Carcinoma Of The Gallbladder

Objectives To investigate the relationship betweeen primary carcinoma of the gallbladder (PCG), providing a theoretical basis for the treatment of PCG.Methods The blood serum and the mucosa and bile of gallbladder samples were collected from 18 patients with PCG, 40 patients with chronic cholecystitis or cholelithiasis (CC), and 20 patients with no PCG and CC (control). The serum IgG against Hp was determined with enzyme linked immunosorbent assay (ELISA). Mucosa and bile fresh samples were submitted to microaerobic culturing. The 16S rDNA-based polymerase chain reaction (PCR) followed by DNA sequence analysis of the obtained PCR fragments was performed. A deveoped searech for Hp was also carried out by PCR, and five genes specific for Hp were amlified. The proteinum UreA, UreB, VacA, and CagA were determined by westerblotting in order to clarity pathogenesis of PCG.Results 1. One day before operation, 88% of serum IgG against Hp were postive in PCG group, 63% in CC group, and 35% in control group. The positive rate in PCG group were significantly higher than the CC group and the control group. The positive rate decreased in PCG and CC groups after operation. There were no statistical difference between the three groups one year after operation. 2. The helicobacters were not successfully cultured in all the three groups. 3. In the PCG group, 81% samples of musca and bile were positive for Helicobacter-specific 16S rRNA gene. In the CC group, 50% samples of musca and bile were positive for Helicobacter-specific 16S rRNA gene. While in the control group, only 20% samples of musca and bile were positive for Helicobacter-specific 16S rRNA gene. The positive rate in PCG group were significantly higher than the CC group and the control group. 4. Of these 16S rDNA sequence of Helicobacter pylori positive samples of musca and bile, 52% samples were positive in cagA, 86% samples were positive in 26KDa, 48% samples were positive in ureA separately. The vacA and rps4 genes were never detected in all the samples of musca and bile. At least one gene were postive in 93% samples of musca and bile. 5. Total of 15 samples of musca and 14 samples of bile were obtained from the PCG patient with Helicobacter-specific 16S rRNA postive. The analysis of these PCR products indicated that they were related most closely to the 16S rDNA sequence of Hp. 6. In the PCG group, 39%, 11%, 6% and 42% samples of musca and bile were positive for the proteinum UreA, UreB, VacA, and CagA separately. In the CC group, 24%, 11%, 8% and 29% samples of musca and bile were positive for the proteinum UreA, UreB, VacA, and CagA separately. In the control group, 7%, 10%, 5% and 10% samples of musca and bile were positive for the proteinum UreA, UreB, VacA, and CagA separately. The positive rate and the mean opitical density of UreA and CagA in PCG group were significantly higher than the CC group and the control group. But there were no statistical difference between the three groups of VacA and UreB.Conclusion It was suggested a higher infection rate in patients with PCG, comared with the CC and control groups. Infection of Hp in the biliary system may be one of the risk factors for occurce of the PCG. The proteinum UreA and CagA may play a important role in the pathogenesis of PCG.