Department of General Surgery, Xinhua Hospital, Shanghai JiaoTong University, School of Medicine, Shanghai, China.
PLoS One. 2013 Jul 30;8(7):e70265. doi: 10.1371/journal.pone.0070265. Print 2013.
Helicobacter pylori has been isolated from 10%-20% of human chronic cholecystitis specimens but the characteristics of "Helicobacter pylori positive cholecystitis" remains unclear. This study aims to compare the clinicopathological features between chronic cholecystitis patients with and without Helicobacter pylori infection in gallbladder mucosa.
Three hundred and twenty-six chronic cholecystitis patients were divided into two groups according to whether Helicobacter pylori could be detected by culture, staining or PCR for Helicobacter 16s rRNA gene in gallbladder mucosa. Positive samples were sequenced for Helicobacter pylori-specific identification. Clinical parameters as well as pathological characteristics including some premalignant lesions and the expression levels of iNOS and ROS in gallbladder were compared between the two groups.
Helicobacter pylori infection in gallbladder mucosa was detected in 20.55% of cholecystitis patients. These patients had a higher prevalence of acid regurgitation symptoms (p = 0.001), more histories of chronic gastritis (p = 0.005), gastric ulcer (p = 0.042), duodenal ulcer (p = 0.026) and higher presence of Helicobacter pylori in the stomach as compared to patients without Helicobacter pylori infection in the gallbladder mucosa. Helicobacter pylori 16s rRNA in gallbladder and gastric-duodenal mucosa from the same individual patient had identical sequences. Also, higher incidences of adenomyomatosis (p = 0.012), metaplasia (p = 0.022) and higher enhanced expressions of iNOS and ROS were detected in Helicobacter pylori infected gallbladder mucosa (p<0.05).
Helicobacter pylori infection in gallbladder mucosa is strongly associated with Helicobacter pylori existed in stomach. Helicobacter pylori is also correlated with gallbladder premalignant lesions including metaplasia and adenomyomatosis. The potential mechanism might be related with higher ROS/RNS production but needs further investigation.
幽门螺杆菌已从 10%-20%的人类慢性胆囊炎标本中分离出来，但“幽门螺杆菌阳性胆囊炎”的特征仍不清楚。本研究旨在比较胆囊黏膜中存在和不存在幽门螺杆菌感染的慢性胆囊炎患者的临床病理特征。
根据胆囊黏膜中幽门螺杆菌能否通过培养、染色或聚合酶链反应检测到幽门螺杆菌 16s rRNA 基因，将 326 例慢性胆囊炎患者分为两组。阳性样本进行幽门螺杆菌特异性鉴定。比较两组患者的临床参数及病理特征，包括一些癌前病变及胆囊中诱导型一氧化氮合酶（iNOS）和活性氧（ROS）的表达水平。
在 20.55%的胆囊炎患者中检测到胆囊黏膜幽门螺杆菌感染。这些患者胃酸反流症状更为常见（p=0.001），慢性胃炎（p=0.005）、胃溃疡（p=0.042）、十二指肠溃疡（p=0.026）病史更多，且胃中幽门螺杆菌的存在率高于胆囊黏膜无幽门螺杆菌感染的患者。同一患者胆囊和胃-十二指肠黏膜中的幽门螺杆菌 16s rRNA 序列相同。此外，在幽门螺杆菌感染的胆囊黏膜中，腺肌增生症（p=0.012）、化生（p=0.022）的发生率更高，iNOS 和 ROS 的表达增强（p<0.05）。
胆囊黏膜中幽门螺杆菌感染与胃中存在的幽门螺杆菌密切相关。幽门螺杆菌与胆囊癌前病变包括化生和腺肌增生症也有关。潜在的机制可能与更高的 ROS/RNS 产生有关，但需要进一步研究。
