Nilsson Hans-Olof, Stenram Unne, Ihse Ingemar, Wadstrom Torkel
Department of Laboratory Medicine, Division of Medical Microbiology, Lund University, Solvegatan 23, S-223 62 Lund, Sweden.
World J Gastroenterol. 2006 May 21;12(19):3038-43. doi: 10.3748/wjg.v12.i19.3038.
To determine whether gastric and enteric Helicobacter species are associated with pancreatic cancer.
Patients with exocrine pancreatic cancer (n = 40), neuroendocrine cancer (n = 14), multiple endocrine neoplasia type 1 (n = 8), and chronic pancreatitis (n = 5) were studied. Other benign pancreatic diseases (n = 10) and specimens of normal pancreas (n = 7) were included as controls. Pancreatic tissue specimens were analyzed by Helicobacter-specific PCR-assay and products were characterized by denaturing gradient electrophoresis and DNA-sequencing. From a subset of the pancreatic cancer patients, gastric and/or duodenal tissue as well as gallbladder and ductus choledochus tissue were analyzed. Gallbladder and choledochus samples were included as controls. Stomach and duodenum samples were investigated to analyze whether a gastric helicobacter might disseminate to the pancreas in pancreatic cancer patients. Pancreatic specimens were analyzed by Bacteroides-specific PCR for detecting the translocation of indigenous gut microbes to the diseased pancreas.
Helicobacter DNA was detected in pancreas (tumor and/or surrounding tissue) of 75% of patients with exocrine cancer, 57% of patients with neuroendocrine cancer, 38% of patients with multiple endocrine neoplasia, and 60% of patients with chronic pancreatitis. All samples from other benign pancreatic diseases and normal pancreas were negative. Thirty-three percent of the patients were helicobacter-positive in gastroduodenal specimens. Surprisingly, H. bilis was identified in 60% of the positive gastroduodenal samples. All gallbladder and ductus choledochus specimens were negative for helicobacter. Bacteroides PCR-assay was negative for all pancreatic samples.
Helicobacter DNA commonly detected in pancreatic cancer suggests a possible role of the emerging pathogens in the development of chronic pancreatitis and pancreatic cancer.
确定胃和肠道幽门螺杆菌属物种是否与胰腺癌相关。
对40例胰腺外分泌癌患者、14例神经内分泌癌患者、8例1型多发性内分泌腺瘤患者和5例慢性胰腺炎患者进行研究。纳入10例其他良性胰腺疾病患者和7例正常胰腺标本作为对照。通过幽门螺杆菌特异性聚合酶链反应（PCR）分析胰腺组织标本，并通过变性梯度凝胶电泳和DNA测序对产物进行鉴定。从一部分胰腺癌患者中，分析胃和/或十二指肠组织以及胆囊和胆总管组织。纳入胆囊和胆总管样本作为对照。对胃和十二指肠样本进行研究，以分析胃癌螺旋杆菌是否可能在胰腺癌患者中扩散至胰腺。通过拟杆菌属特异性PCR分析胰腺标本，以检测肠道内源性微生物向患病胰腺的移位。
在75%的胰腺外分泌癌患者、57%的神经内分泌癌患者、38%的多发性内分泌腺瘤患者和60%的慢性胰腺炎患者的胰腺（肿瘤和/或周围组织）中检测到幽门螺杆菌DNA。其他良性胰腺疾病和正常胰腺的所有样本均为阴性。33%的患者胃十二指肠标本中幽门螺杆菌呈阳性。令人惊讶的是，在60%的阳性胃十二指肠样本中鉴定出胆汁幽门螺杆菌。所有胆囊和胆总管标本的幽门螺杆菌检测均为阴性。所有胰腺样本的拟杆菌PCR分析均为阴性。
在胰腺癌中普遍检测到幽门螺杆菌DNA，提示这些新出现的病原体在慢性胰腺炎和胰腺癌的发生发展中可能发挥作用。
