Abstract
Background 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.MethodsThree 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.Results 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).Conclusions 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.
Highlights
Chronic cholecystitis is one of the most prevalent diseases requiring surgical intervention
H. pylori infection in gallbladder mucosa was detected in 20.55% (n = 67) of the cholecystitis patients (Figure 1 and 2). 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 a higher positive rate of Helicobacter pylori (p,0.05) in the stomach as compared to patients without Helicobacter pylori infection in the gallbladder (Table 2)
Considering that H. pylori-16s rRNA in gallbladder and gastric-duodenal mucosa from the same individual patient had completely identical sequences, we hypothesize that H.pylori in the gastrointestinal system might be a potential candidate for increasing the risk of chronic inflammation of the gallbladder
Summary
Chronic cholecystitis is one of the most prevalent diseases requiring surgical intervention. The causes of chronic cholecystitis still remain unclear. Our previous meta-analysis demonstrated that Helicobacter pylori (H.pylori) in human biliary system was correlated with chronic cholecystitis, especially in the regions with higher prevalence of this infectious agent such as South Asia, East Asia and Latin America. 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
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