Ma Xiaoying, Wang Heju, Zhang Peng, Xu Lin, Tian Zibin
Department of Gastroenterology, Qingdao University School of Medicine, Qingdao Municipal Hospital, Shandong, China.
Department of Gastroenterology, Affiliated Hospital to Qingdao University, Shandong, China.
Turk J Gastroenterol. 2019 Feb;30(2):177-183. doi: 10.5152/tjg.2018.17512.
BACKGROUND/AIMS: Multiple factors have been linked to pathogenesis of pancreatic cancer and cholangiocarcinoma. Until now, few studies have investigated the role of small intestinal bacterial overgrowth (SIBO) and toll-like receptor 4 (TLR-4) signaling in these diseases. This study aimed to examine the relationship between the prevalence of SIBO and the TLR-4 expression in patients with pancreatic carcinoma and cholangiocarcinoma.
A total of 90 human subjects suffering from pancreatic carcinoma (n=30), cholangiocarcinoma (n=30), and healthy controls (n=30) were enrolled in the study. A glucose hydrogen breath test (GHBT) was used to evaluate SIBO. The TLR4 protein expression was measured by immunohistochemistry (IHC).
The positive rate of SIBO was 63.3% in the pancreatic cancer group and 46.7% in patients with cholangiocarcinoma, which was significantly greater than 13.3% in the healthy control group (p<0.05). An IHC analysis revealed that the TLR-4 protein expression in the SIBO-positive pancreatic carcinoma patients was significantly higher than that in the SIBO-negative patients (p<0.05), and the same result was in the cholangiocarcinoma subjects. In addition, a correlation analysis identified the positive relationship between the prevalence of SIBO and the TLR-4 protein expression in pancreatic carcinoma (r=0.489), and the same result was in the cholangiocarcinoma subjects.
Our findings indicate a high prevalence of SIBO in pancreatic carcinoma and cholangiocarcinoma, and SIBO displays a positive correlation with the TLR-4 expression, suggesting that SIBO could be a risk factor for the pathogenesis of pancreatic carcinoma and cholangiocarcinoma, in which the TLR4 signaling may be involved.
背景/目的：多种因素与胰腺癌和胆管癌的发病机制相关。迄今为止，很少有研究探讨小肠细菌过度生长（SIBO）和Toll样受体4（TLR - 4）信号通路在这些疾病中的作用。本研究旨在探讨胰腺癌和胆管癌患者中SIBO的患病率与TLR - 4表达之间的关系。
本研究共纳入90名受试者，其中胰腺癌患者30例、胆管癌患者30例和健康对照者30例。采用葡萄糖氢呼气试验（GHBT）评估SIBO。通过免疫组织化学（IHC）检测TLR4蛋白表达。
胰腺癌组SIBO阳性率为63.3%，胆管癌患者为46.7%，均显著高于健康对照组的13.3%（p<0.05）。免疫组织化学分析显示，SIBO阳性的胰腺癌患者中TLR - 4蛋白表达显著高于SIBO阴性患者（p<0.05），胆管癌患者也有相同结果。此外，相关性分析确定了胰腺癌中SIBO患病率与TLR - 4蛋白表达之间呈正相关（r = 0.489），胆管癌患者也有相同结果。
我们的研究结果表明，胰腺癌和胆管癌中SIBO的患病率较高，且SIBO与TLR - 4表达呈正相关，提示SIBO可能是胰腺癌和胆管癌发病机制的一个危险因素，其中TLR4信号通路可能参与其中。
