Lu Yun, Zhang Bing-Yuan, Shi Jing-Sen, Wu Li-Qun
Department of Hepatobiliary-Vascular Surgery, Affiliated Hospital of Medical College, Qingdao University, Qingdao 266003, China.
Hepatobiliary Pancreat Dis Int. 2004 Feb;3(1):133-5.
The major causive factors of gallbladder carcinoma are very complex. Cholecystitis with gallstone was reported one of the most important factors. Many research revealed that cholecystitis or gallstone can give rise to epithelial hyperplasia of gallbladder mucusa or canceration secondarily. In this study, 46 patients were detected in order to find the relationship between infection of different bacteria and formation of gallbladder carcinoma.
Using the common gene primer of bacteria 16S ribosomal RNA (rRNA), we detected bacterial gene fragments of gallbladder carcinoma tissues in 46 patients by polymerase chain reaction (PCR). Relative bile was also detected by PCR in 18 patients who underwent operations, including U-tube drainage (1), right or left biliary tube drainage (4), radical cholecystectomy (9), and cholecystorrhaphy (4). The tissue fragments of gallbladder carcinoma from the remaining 28 patients were paraffin slices.
The positive rate of bacterial DNA in gallbladder carcinoma tissue was 78.3% (36/46). The sequence of 16S ribosomal RNA gene fragments amplified by PCR was approximately 371 base pairs (bp). Multiple kinds of standard bacterial gene fragments obtained from 36 patients included Colibacillus, B.fragilis, Klebsiella, C.perfringens and Clostridium, with a positive rate of 78.3% (36/46). Among the 36 patients, 14 patients with gallbladder carcinoma received operation and their relative bile at operation was detected bacterial gene fragments with a positive rate of 77.8% (14/18). This result was close to that in gallbladder carcinoma tissues.
Our results suggested that there might be a relationship between occurrence of gallbladder carcinoma and infection of different kinds of bacteria, especially anaerobic bacteria C.perfringens. This reminds us that the gallbladder mucosa stimulated by anaerobic and aerobic bacteria might be the principal cause for the development of carcinoma.
胆囊癌的主要致病因素非常复杂。胆囊炎合并胆结石被报道为最重要的因素之一。许多研究表明，胆囊炎或胆结石可继发引起胆囊黏膜上皮增生或癌变。在本研究中，检测了46例患者，以寻找不同细菌感染与胆囊癌形成之间的关系。
使用细菌16S核糖体RNA（rRNA）的通用基因引物，通过聚合酶链反应（PCR）检测46例患者胆囊癌组织的细菌基因片段。对18例接受手术的患者的相关胆汁也进行了PCR检测，包括U形管引流（1例）、左右胆管引流（4例）、根治性胆囊切除术（9例）和胆囊缝合术（4例）。其余28例患者的胆囊癌组织片段制成石蜡切片。
胆囊癌组织中细菌DNA的阳性率为78.3%（36/46）。PCR扩增的16S核糖体RNA基因片段序列约为371个碱基对（bp）。从36例患者中获得的多种标准细菌基因片段包括大肠杆菌、脆弱拟杆菌、克雷伯菌、产气荚膜梭菌和梭状芽孢杆菌，阳性率为78.3%（36/46）。在这36例患者中，14例胆囊癌患者接受了手术，术中其相关胆汁检测到细菌基因片段，阳性率为77.8%（14/18）。该结果与胆囊癌组织中的结果相近。
我们的结果表明，胆囊癌的发生可能与多种细菌感染有关，尤其是厌氧菌产气荚膜梭菌。这提醒我们，厌氧和需氧菌刺激的胆囊黏膜可能是癌变发生的主要原因。
