Research

Helicobacter hepaticus does not Increases the Risk of Gallbladder Cancer: Results of A Case Control Study and Literature Review

Ruhi Dixit, Vineeta Shrivastava, Gopal Nath, Mridula Shukla and Manoj Pandey
World Journal of Epidemiology and Cancer Prevention 2017, 6:2

Abstract

Introduction

Gallbladder cancer is one of the few cancers that are associated with bacterial infections and inflammation. Of many bacteria, Helicobacter has been found to be associated with gastric MALToma, gastric adenocarcinoma and hepatobiliary neoplasms. We studied the presence of the Helicobacter hepaticus in carcinoma of the gallbladder using cholelithiasis as control.

Patients and methods

Fifty four gallbladder cancer and 55 controls with cholelithiasis were studied with Helicobacter culture and PCR for the Helicobacter hepaticus using flagellin-A gene primers. Relative risk and odds ratio with 95% CI were estimated. An extensive review of literature was carried out and data was analyzed using cumulative odds ratio.

Results

Helicobacter hepaticus was identified in 22/54 patients and 18/55 controls by culture, Flagellin A PCR products were seen in 14/54 cancer and 8/55 controls. The difference was statistically not significant (p=0.107). The relative risk of gallbladder cancer in H. hepaticus culture positive cases was 0.606 (95% CI 0.418 to 0.717), while risk of gallbladder cancer increased on detection by flagellin gene (OR 1.78 (95% CI 0.81-3.09) though this was statistically not significant. Overall after inclusion of all cases from literature 55/294 cases and 128/377 controls had H hepaticus infection the cumulative odds ratio was 0.4477 (95 % CI: 0.3116 to 0.6432) which was statistically significant.

Conclusions

The present study demonstrates no increased risk of gallbladder cancer in presence of Helicobacter hepaticus. The variability in methods of detection and use of variable cases and controls leads to heterogeneity in the sample that makes it difficult to interpret these results.

Key words

Cancer; neoplasm; hepatobiliary; pancreas; gallstones; cholangiocarcinoma.

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