Is Salmonella enterica serovar Typhi associated with carcinoma gall bladder?

Abstract

Introduction: Gallbladder carcinoma is a common hepatobiliary malignancy with poor prognosis. It is 3rd commonest malignancy in north India. Salmonella typhi is one of risk factor for gallbladder cancer. India is high endemic area for typhoid in the world. Various authors reported association between the two but without doing testing for typhoid carrier, association cannot be proven. Aim: The present study was designed to explore the association of the chronic typhoid carrier state and carcinoma gall bladder by detecting Salmonella typhi in specimens of gallbladder from patients with malignant and benign gallbladder diseases using a Nested PCR. Methods and material: In this prospective case control study, we have got 39 samples from Carcinoma Gall Bladder (GBC) patients as cases and 75 samples from benign Gall Bladder Diseases (GBD) patients as controls in two years duration. We have done Indirect haemagglutination test for typhoid carrier from five milliliters of blood which was collected from each patient before surgery. Nested PCR was done from gall bladder tissue, which was taken at operation, from both GBC and GBD patients. Result: Nested PCR showed 59% positivity for Salmonella typhi in the GBC and 56% in GBD, so association of Salmonella typhi with GBC was not statistically significant. Vi antibody was present 33% in GBC and 37% in GBD by IHA. It is also not statistically significant. Conclusion: A large number of sample size is require for proving association between carcinoma gall bladder and Salmonella typhi by using definite marker for Vi antibodies.