Bayerdörffer E, Mannes G A, Richter W O, Ochsenkühn T, Wiebecke B, Köpcke W, Paumgartner G
Medical Department II, University of Munich, Germany.
Gastroenterology. 1993 Jan;104(1):145-51. doi: 10.1016/0016-5085(93)90846-5.
Epidemiological and animal studies have suggested that the secondary bile acid deoxycholic acid is cocarcinogenic in colorectal cancer, but this hypothesis was not confirmed by case-control studies investigating fecal bile acids.
Individual serum bile acid concentrations were investigated in 25 men and 25 women with colorectal adenomas and in an equal number of age- and sex-matched controls by gas-liquid chromatography.
Deoxycholic acid levels were significantly higher in the sera of men with colorectal adenomas (1.70 +/- 0.59 vs. 1.16 +/- 0.39 mumol/L, P < 0.0005) and in a combined analysis of both sexes (1.47 +/- 0.78 vs. 1.08 +/- 0.39 mumol/L, P < 0.0025). Six- and 12-month follow-up measurements of deoxycholic acid concentrations in a subgroup of 22 men and 17 women showed higher serum levels in men with adenomas, indicating that measurement of deoxycholic acid concentration may be a reliable parameter to investigate its pathogenetic role in colonic neoplasia.
The data of this study support the hypothesis that deoxycholic acid may play a role in the pathogenesis of colorectal cancer.
流行病学和动物研究表明，次级胆汁酸脱氧胆酸在结直肠癌中具有协同致癌作用，但调查粪便胆汁酸的病例对照研究并未证实这一假说。
采用气液色谱法对25名患有结肠直肠腺瘤的男性和25名患有结肠直肠腺瘤的女性以及数量相等的年龄和性别匹配的对照者的个体血清胆汁酸浓度进行了调查。
患有结肠直肠腺瘤的男性血清中的脱氧胆酸水平显著更高（1.70±0.59对1.16±0.39μmol/L，P<0.0005），在对两性进行的综合分析中也是如此（1.47±0.78对1.08±0.39μmol/L，P<0.0025）。对22名男性和17名女性亚组的脱氧胆酸浓度进行6个月和12个月的随访测量显示，患有腺瘤的男性血清水平更高，这表明测量脱氧胆酸浓度可能是研究其在结肠肿瘤发生中的致病作用的一个可靠参数。
本研究数据支持脱氧胆酸可能在结直肠癌发病机制中起作用这一假说。
