Detection of Helicobacter bilis in Bile from Thai Patients with Adenocarcinoma of Biliary Tract
Abstract
Objectives: There is a high incidence of the biliary tract carcinoma in the Northern part of Thailand. Almost all of them are in advanced stage. Some data support an association of bile resistant bacteria, namely Helicobacter bilis which may play a causative role in the development of biliary tract carcinoma. Previous study had shown that animal infected with this bacteria developed malignant liver tumor. This study was designed to search for the Helicobacter bilis in bile that may play a causative role for malignancy of biliary tract.
Patients and Methods: From July to December 1999, bile samples were collected from 40 Thai patients with benign and malignant diseases of biliary tract who underwent surgical and radiological intervention in the Faculty of Medicine, Chiang Mai University. Collection of bile sample with sterile technique was obtained by sterile needle aspiration immediately after definitive procedures were performed for treatment. Patients who had antibiotics within 7 days before bile collection were excluded. Diagnostic evaluation, surgical procedures, and pathologic examination were reviewed. The specific part of DNA sequence of Helicobacter bilis were identified by PCR analysis and DNA sequencing in six random positive cases.
Results: Twenty six cases had benign diseases and 14 cases had malignant diseases. There were positive results by PCR analysis and DNA sequencing in 79 per cent (11/14) of malignancy cases and in 38 per cent (10/26) of benign cases. The positive rates of infection between malignancy and benign groups were statistically significant differences (p < 0.05). Identification of positive Helicobacter bilis was statistically significant compared with negative Helicobacter bilis in the malignant biliary tract diseases at an odds ratio of 2.04 (95%CI1.17-3.57).
Conclusion: Helicobacter bilis was found in human biliary tract malignancies of Thai patients. This bile resistant bacteria may be a risk factor in the pathogenesis of biliary tract malignancies.
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