Skip to main content
SpringerLink
Log in

Carcinoma of the Gallbladder—Is It a Sequel of Typhoid?

  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

Gallbladder diseases, including carcinoma, are common in the northern part of India and so are Salmonella typhi infection and typhoid carrier state. This study was aimed to find out the association of typhoid carrier state in patients with cholelithiasis, carcinoma of the gallbladder, and controls. The three groups are comparable in age and sex composition. This is the first study of its kind from an area of high endemicity for both typhoid infection and carcinoma of the gallbladder. A case–control study was carried out to detect typhoid carrier state among the patients with biliary diseases and healthy controls, using indirect haemagglutination assay measuring antibodies against highly purified S. typhi Vi polysaccharide antigen. A significantly high Vi positivity was observed in patients with gallbladder carcinoma (29.4%) compared to controls (5%) (χ2 = 6.325, P < 0.004, OR = 7.19) and patients with cholelithiasis (10.7%) (χ2 = 5.066, P < 0.01, OR = 3.86). There is 8.47 times more risk of developing carcinoma of the gallbladder in culture-positive typhoid carriers than the noncarriers. The present study suggests the typhoid carrier state to be one of the possible mechanisms of gallbladder carcinogenesis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

REFERENCES

  1. Shukla VK, Khandelwal C, Roy SK, Vaidya MP: Primary carcinoma of the gallbladder: A review of a 16 year period at the University Hospital. J Surg Oncol 28:32-35, 1985

    Google Scholar 

  2. Welton JC, Marr JS, Friedman SM: Association between hepatobiliary cancer and typhoid carrier state. Lancet 1:791-794, 1979

    Google Scholar 

  3. Hill MJ: Microbes and Human Carcinogenesis. London, Edward Arnold, 1986

    Google Scholar 

  4. Kinoshita N, Gelboin HV: β-Glucoronidase calatysed hydrolysis of benzo[a]pyrene-3-glucoronide and binding to DNA. Science 199:307-310, 1978

    Google Scholar 

  5. Shukla VK, Tiwari SC, Roy SK: Biliary bile acids in cholelithiasis and carcinoma of the gallbladder. Eur J Cancer Prev 2:155-160, 1993

    Google Scholar 

  6. Ledingham JCG: The carrier problem in enteric fever. In The Carrier Problem in Infectious Diseases. JCG Ledingham, JA Arkwright (eds). London, Edward Arnold, 1912

    Google Scholar 

  7. Pandey M, Vishwakarma RA, Khatri AK, Roy SK, Shukla VK: Bile, bacteria and carcinogenesis. J Surg Oncol 58:282-283, 1995

    Google Scholar 

  8. Lin FYC, Becke JM, Croves C, Lim BP, Israel E, Becker EF, Helfrich RM, Swetter DS, Caramton T, Robbins JB: Restaurant associated outbreak of typhoid fever in Maryland: Identification of carrier facilitated by measurement of serum VI antibodies. J Clin Microbiol 26:1194-1197, 1988

    Google Scholar 

  9. Lanata CF, Levine MM, Ristori C, Black RE, Jimenez L, Salcedo M, Garcia J, Sotomayor V: Vi serology in detection of chronic Salmonella typhoid carriers in an endemic area. Lancet 1:441-442, 1983

    Google Scholar 

  10. Shioler H, Christiansen ED, Haybye G: Biliary calculi in chronic Salmonella carriers and healthy controls: A controlled study. Scand J Infect Dis 15:17-19, 1983

    Google Scholar 

  11. Mellemgaard A, Gaarslev K: Risk of hepatobiliary cancer in carriers of Salmonella typhi. J Natl Cancer Inst 80:288, 1988

    Google Scholar 

  12. Caygill CPJ, Hill MJ, Braddick M, Sharp JCM: Cancer mortality in chronic typhoid and paratyphoid carriers. Lancet 343:83-84, 1994

    Google Scholar 

  13. Caygill CPJ, Braddick M, Hill MJ, Knowles RL, Sharp JCM: The association between typhoid carriage, typhoid infection and subsequent cancer at a number of sites. Eur J Cancer Prev 4:187-193, 1995

    Google Scholar 

  14. Nolan CM, Freeley JC, White PC, Hombie EA, Browo SL, Wong KH: Evaluation of a new assay for Vi antibody in chronic carriers of Salmonella typhi. J Clin Microbiol 12:22-36, 1980

    Google Scholar 

  15. Edelman R, Levine MM: Summary of an international workshop on typhoid fever. Rev Infect Dis 8(3):329-349, 1986

    Google Scholar 

  16. Dinbar A, Altmann G, Tulcinsky DB: The treatment of chronic biliary Salmonella carriers. Am J Med 47:236, 1969

    Google Scholar 

  17. Singh H, Pandey M, Shukla VK: Salmonella carrier state, chronic bacterial infection and gallbladder carcinogenesis. Eur J Cancer Prev 5:1, 1996

    Google Scholar 

  18. El-Zayadi, Ghoneim M, Kabil SM: Bile duct carcinoma in Egypt-possible aetiological factors. Hepato-Gastroenterol 38:337-340, 1991

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Departments of Surgery, Statistics, and Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221 005, India

    Vijay K. Shukla, Harbans Singh, Manoj Pandey, S.K. Upadhyay & Gopal Nath

Authors
  1. Vijay K. Shukla
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Harbans Singh
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Manoj Pandey
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. S.K. Upadhyay
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Gopal Nath
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Shukla, V.K., Singh, H., Pandey, M. et al. Carcinoma of the Gallbladder—Is It a Sequel of Typhoid?. Dig Dis Sci 45, 900–903 (2000). https://doi.org/10.1023/A:1005564822630

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1005564822630

Search

Navigation