Hassan Ehsan Hassan, Gerges Shawkat S, El-Atrebi Kamal A, El-Bassyouni Hala T
Pathology Department, National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt.
Surgery Department, National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt.
Tumour Biol. 2015 Sep;36(9):7093-8. doi: 10.1007/s13277-015-3444-9. Epub 2015 Apr 16.
Recent work demonstrated the presence of Helicobacter pylori (H. pylori) in the bile and gallbladder of more than 75 % of patients with gallbladder cancer and more than 50 % of patients with chronic cholecystitis. The aim of the work was to determine the prevalence of H. pylori in the gallbladder of patients operated on for chronic cholecystitis and relating their presence to the precancerous histological changes. In our study, fifty patients were operated on for chronic cholecystitis. The patients were subdivided into two groups (each includes 25 patients): H. pylori-positive group, who had H. pylori in their gallbladder mucosa detected by Giemsa stain, and H. pylori-negative group. The histological findings (mucosal erosions, atrophy, metaplasia, dysplasia, lymphoid infiltration, musculosa hypertrophy, and fibrosis) were compared between the two groups. Comparing the histological findings of the H. pylori-infected gallbladders with the non-infected ones, the gallbladders with mucosal hyperplasia, metaplasia/dysplasia, and lymphoid infiltration showed statistically significant differences, with a P value of 0.028, 0.049, and 0.022, respectively. On the other hand, no statistically significant differences were detected between the two groups in the degree of mucosal erosions (P = 0.299), atrophy, musculosa hypertrophy (P = 1.000), and fibrosis (P = 1.000). These results highlight the role of H. pylori infection in aggravating the mucosal lesions (mucosal hyperplasia, metaplasia, and lymphoid infiltration) of the gallbladder that is considered potentially precancerous.
最近的研究表明，超过75%的胆囊癌患者和超过50%的慢性胆囊炎患者的胆汁和胆囊中存在幽门螺杆菌（H. pylori）。这项研究的目的是确定接受慢性胆囊炎手术患者胆囊中幽门螺杆菌的患病率，并将其存在情况与癌前组织学变化相关联。在我们的研究中，50例患者接受了慢性胆囊炎手术。患者被分为两组（每组25例）：幽门螺杆菌阳性组，通过吉姆萨染色在其胆囊黏膜中检测到幽门螺杆菌；以及幽门螺杆菌阴性组。比较了两组的组织学发现（黏膜糜烂、萎缩、化生、发育异常、淋巴浸润、肌层肥厚和纤维化）。将幽门螺杆菌感染的胆囊与未感染的胆囊的组织学发现进行比较，发现有黏膜增生、化生/发育异常和淋巴浸润的胆囊存在统计学显著差异，P值分别为0.028、0.049和0.022。另一方面，两组在黏膜糜烂程度（P = 0.299）、萎缩、肌层肥厚（P = 1.000）和纤维化（P = 1.000）方面未检测到统计学显著差异。这些结果突出了幽门螺杆菌感染在加重胆囊黏膜病变（黏膜增生、化生和淋巴浸润）方面的作用，而这些病变被认为具有潜在的癌前性。
