Chen W, Li D, Cannan R J, Stubbs R S
Wakefield Gastroenterology Centre and Research Institute, Wakefield Hospital, Wellington, New Zealand.
Dig Liver Dis. 2003 Apr;35(4):237-43. doi: 10.1016/s1590-8658(03)00060-4.
Several species of Helicobacter colonise the biliary tract of animals and cause hepatobiliary diseases. Helicobacter species have also been identified in the gallbladder of a high proportion of Chilean patients with gallbladder cancer.
To determine the presence of Helicobacter species, particularly Helicobacter pylori and Helicobacter bilis, in the gallbladder of patients with non-malignant gallbladder diseases and control patients.
DNA was extracted from gallbladder samples from 122 consecutive patients undergoing cholecystectomy. The presence of Helicobacter genus-specific or Helicobacter pylori and Helicobacter bilis species-specific DNA was determined by polymerase chain reaction and sequence analysis. The presence of Helicobacter pylori-specific immunoglobulin G in the serum (n=84) and bile (n=104) samples was determined by enzyme linked immunosorbent assay.
Helicobacter DNA was detected in 61 (50.0%) gallbladder samples: 29 of 60 (48.3%) patients with symptomatic gallstone, six of 10 (60.0%) patients with asymptomatic gallstones, 11 of 15 (73.3%) patients with other biliary diseases, and 15 of 37 (40.5%) control patients, respectively. Among them, 39 samples were positive for Helicobacter pylori but none were positive for Helicobacter bilis. Sequence analysis of Helicobacter genus-positive samples showed that 56 samples were Helicobacter pylori and five were Helicobacter species 'Liver 3' strain. Overall, there was no significant difference in the detection rate of Helicobacter DNA or the levels of serum and bile Helicobacter pylori-specific immunoglobulin G in the various biliary disease groups compared with control patients. Neither was there any significant difference in the blood biochemistry and liver function tests between patients with positive and negative Helicobacter DNA detection.
Helicobacter species' DNA are commonly present in the gallbladder of patients with gallstone diseases and in controls, implying that Helicobacter infection alone may not play a significant role in the formation of gallstones. However, our results do not exclude the possibility of Helicobacter infection as a cofactor in the development of gallstones.
多种幽门螺杆菌属细菌定殖于动物胆道并引发肝胆疾病。在智利高比例胆囊癌患者的胆囊中也已鉴定出幽门螺杆菌属细菌。
确定非恶性胆囊疾病患者及对照患者胆囊中幽门螺杆菌属细菌的存在情况，尤其是幽门螺杆菌和胆汁幽门螺杆菌。
从122例连续接受胆囊切除术的患者的胆囊样本中提取DNA。通过聚合酶链反应和序列分析确定幽门螺杆菌属特异性或幽门螺杆菌及胆汁幽门螺杆菌种特异性DNA的存在情况。通过酶联免疫吸附测定法测定血清（n = 84）和胆汁（n = 104）样本中幽门螺杆菌特异性免疫球蛋白G的存在情况。
在61份（50.0%）胆囊样本中检测到幽门螺杆菌DNA：有症状胆结石患者60例中的29例（48.3%）、无症状胆结石患者10例中的6例（60.0%）、其他胆道疾病患者15例中的11例（73.3%）以及对照患者37例中的15例（40.5%）。其中，39份样本幽门螺杆菌呈阳性，但无一例胆汁幽门螺杆菌呈阳性。幽门螺杆菌属阳性样本的序列分析显示，56份样本为幽门螺杆菌，5份为幽门螺杆菌“肝脏3”菌株。总体而言，与对照患者相比，各胆道疾病组中幽门螺杆菌DNA的检测率或血清及胆汁中幽门螺杆菌特异性免疫球蛋白G的水平无显著差异。幽门螺杆菌DNA检测呈阳性和阴性的患者之间的血液生化和肝功能检查也无显著差异。
幽门螺杆菌属细菌的DNA常见于胆结石疾病患者及对照患者的胆囊中，这意味着单纯的幽门螺杆菌感染可能在胆结石形成中不起重要作用。然而，我们的结果并不排除幽门螺杆菌感染作为胆结石发病的辅助因素的可能性。
