PDF | https://doi.org/10.46613/congastro2023-25
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COOK P1, Lagos R2, Hormazabal J3, Viñuela E4, Aguayo G5, Koshiol J6, Levine M7, Ferreccio C8
1UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL, CHAPEL HILL, Estados Unidos (EEUU)
2Centro para Vacunas en Desarrollo (CVD-Chile), SANTIAGO, Chile
3Departamento de Laboratorio Biomédico, Instituto de Salud Pública, SANTIAGO, Chile
4Servicio de Cirugía, Hospital Sótero del Río, SANTIAGO, Chile
5Servicio de Anatomía Patológica, Hospital Sótero del Río, SANTIAGO, Chile
6Division of Cancer Epidemiology and Genetics, Infections and Immunoepidemiology Branch, National Cancer Institute, Bethesda, Maryland, Estados Unidos (EEUU)
7Center for Vaccine Development (CVD), University of Maryland School of Medicine (UMSoM),, Baltimore, Estados Unidos (EEUU)
8Facultad de Medicina, Pontificia Universidad Católica de Chile,, SANTIAGO, Chile
Introduction:Chile has high mortality for gallbladder cancer (GBC). Gallstones are the primary risk factor, however, 1-3% of cholelithiasis cases develop GBC. Chronic carriage of Salmonella Typhi (ST) is more prevalent among gallstones carriers, suggesting a potential risk factor for GBC. A previous study found prevalences of 3.8% for ST and 3.5% for S.Paratyphi A/B in chilean patients undergoing cholecystectomies.
Objective:To analyze preneoplastic lesions and ST carriage in patients undergoing elective cholecystectomy.
Methods:Between 2017-2019, we enrolled 2,247 patients at four Santiago hospitals. Histopathological examination, culture, and PCR were performed on bile and gallstones. IgG Vi antibodies were tested in sera. 1216(54.2%) participants were 55 years, while 1031 (45.8%) were between 18-34 years-old.
Results: 468 individuals had preneoplastic lesions: 381(17.0%) metaplasia, 56(2.5%) LGD, 10(0.5%) HGD, and 21(0.9%) GBC. Young women had higher prevalence of lesions than men (OR=3.1(1.6-6.1)). The presence of gallstones was associated with a higher incidence of lesions in both age groups (OR=2.0 (1.5-2.8)). We did not culture ST. One older woman tested positive for S. Paratyphi B in the bile culture. Three older participants had positive PCR for ST in gallstones, and one of them had a positive PCR for ST in bile. Among them, two participants had high levels of anti-Vi antibodies, indicating potential chronic carriage. Only one of the four cases (S. Paratyphi B) had a gallbladder lesion (GBC).
The overall prevalence of ST/S.Paratyphi was low(1.8/1000 cases). However, among individuals with high-grade dysplasia and worse lesions (32.3/1000; PRR:8.9 (1.8-43.5)), it was much higher.
Conclusion: The study suggests a possible link between chronic ST/Paratyphi infection and preneoplastic lesions in the older group, including GBC. However, due to the low prevalence of suspicious chronic carriers, it is challenging to separate this effect from the effect of age itself.
