Pellicano Rinaldo, Mazzaferro Vincenzo, Grigioni Walter Franco, Cutufia Miguel Angel, Fagoonee Sharmila, Silengo Lorenzo, Rizzetto Mario, Ponzetto Antonio
Ambulatorio di Gastroenterologia, Ospedale S Giovanni Battista, Via Chiabrera 34, III piano, 10126 Torino, Italy.
World J Gastroenterol. 2004 Feb 15;10(4):598-601. doi: 10.3748/wjg.v10.i4.598.
Only a minority of patients carrying a defined viral aetiologic agent develop cirrhosis and ultimately hepatocellular carcinoma (HCC), the mechanism underlying the worsening is still undefined. Experimental infection by Helicobacter hepaticus in mice causes chronic hepatitis and HCC and recently, more Helicobacter species (Helicobacter spp.) have been detected in the liver of patients suffering from cholestatic diseases and HCC arising from non-cirrhotic liver. We investigated whether Helicobacter spp. sequences could be detected in the liver of patients with cirrhosis and HCC compared to subjects with metastasis to liver from colon cancer.
Twenty-three liver samples from patients operated upon for HCC superimposed on hepatitis C virus (HCV)-related cirrhosis and 6 from patients with resected metastases from colorectal cancer, were tested by polymerase chain reaction for presence of genomic 16S rRNA of Helicobacter genus using specific primers. DNA sequencing and cag A gene analysis were also performed.
Genomic sequences of Helicobacter spp. were found in 17 of 20 (85%) liver samples from patients with HCC and in 2 of 6 samples from patients with liver metastasis. In three samples of the first group the result was uncertain. H pylori was revealed in 16 out of 17 positive samples and Helicobacter pullorum in the other.
Helicobacter spp., carcinogenic in mice, were found at a higher frequency in the liver of patients with HCV-related cirrhosis and HCC than those in patients without primary liver disease.
携带特定病毒病原体的患者中只有少数会发展为肝硬化并最终发展为肝细胞癌(HCC),病情恶化的潜在机制仍不明确。小鼠实验性感染肝螺杆菌会导致慢性肝炎和HCC,最近,在患有胆汁淤积性疾病和非肝硬化性肝脏引起的HCC患者的肝脏中检测到了更多的螺杆菌属(Helicobacter spp.)。我们调查了与结肠癌肝转移患者相比,肝硬化和HCC患者肝脏中是否能检测到螺杆菌属序列。
对23例因HCC叠加丙型肝炎病毒(HCV)相关肝硬化而接受手术的患者的肝脏样本和6例因结直肠癌肝转移而接受切除手术的患者的肝脏样本,使用特异性引物通过聚合酶链反应检测螺杆菌属基因组16S rRNA的存在。还进行了DNA测序和cag A基因分析。
在20例HCC患者的17份(85%)肝脏样本和6例肝转移患者的2份样本中发现了螺杆菌属的基因组序列。第一组的3份样本结果不确定。17份阳性样本中有16份检测出幽门螺杆菌,另一份检测出鸡螺杆菌。
在HCV相关肝硬化和HCC患者的肝脏中,致癌的螺杆菌属的检出频率高于无原发性肝病的患者。