胆胰管汇合异常患者胆道系统内胆汁幽门螺旋杆菌定植。

Helicobacter bilis colonization of the biliary system in patients with pancreaticobiliary maljunction.

机构信息

Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan.

出版信息

Br J Surg. 2010 Apr;97(4):544-9. doi: 10.1002/bjs.6907.

DOI:10.1002/bjs.6907

PMID:20155791

Abstract

BACKGROUND

Helicobacter bilis is considered to be a causative factor in the pathogenesis of biliary cancer. This study investigated the prevalence of H. bilis colonization of the biliary system of patients with pancreaticobiliary maljunction (PBM).

METHODS

Bile juice and biliary tissue samples were collected from 17 patients with PBM and 27 controls who had benign biliary disease without PBM. DNA extracted from each biliary sample was subjected to polymerase chain reaction (PCR) analysis for H. bilis and Helicobacter pylori.

RESULTS

PCR assays revealed that 12 of the 17 patients with PBM were positive for H. bilis DNA, compared with eight of 27 patients without PBM (P = 0.009). Among patients with PBM, H. bilis DNA was identified in six of eight children, including a 2-month-old infant, and in six of nine adults. The high prevalence of H. bilis DNA in the biliary system of patients with PBM was independent of age, sex, common bile duct dilatation, configuration of the pancreatic and bile ducts, and amylase activity in bile.

CONCLUSION

H. bilis colonization of the biliary system is extremely common in patients with PBM. This may point to a role in the pathogenesis of biliary cancer.

摘要

背景

胆汁幽门螺旋杆菌被认为是胆管癌发病机制中的一个致病因素。本研究调查了具有胰胆管合流异常（PBM）的患者胆道系统中胆汁幽门螺旋杆菌定植的流行情况。

方法

从 17 例具有 PBM 的患者和 27 例无 PBM 的良性胆道疾病对照者的胆汁和胆道组织中采集样本。从每个胆道样本中提取的 DNA 均进行聚合酶链反应（PCR）分析，以检测 H. bilis 和幽门螺旋杆菌。

结果

PCR 检测显示，17 例 PBM 患者中有 12 例 H. bilis DNA 阳性，而 27 例无 PBM 患者中有 8 例阳性（P = 0.009）。在 PBM 患者中，H. bilis DNA 存在于 8 例儿童中的 6 例（包括 1 例 2 个月大的婴儿）和 9 例成人中的 6 例。PBM 患者胆道系统中 H. bilis DNA 的高流行率与年龄、性别、胆总管扩张、胰胆管形态和胆汁中淀粉酶活性无关。