Abstract
The elevated incidence of large bowel carcinoma after cholecystectomy has long been controversial. The pathomechanism of this entity, however, is still unclear. Many authors have demonstrated a correlation between cholecystokinin (CCK) and gastrin levels and the occurrence of colorectal cancer. As yet, no clear data are available on the potential impact of cholecystectomy on CCK level alterations. Moreover, no reports have yet been published on CCK receptors. We have investigated the role of CCK-8 and gastrin plasma levels in patients with prior cholecystectomy and CCK receptor levels in patients with colorectal cancer. 125 patients entered a prospective study. Of these, 45 served as controls. 40 patients had prior cholecystectomy, 5 patients underwent cholecystectomy during the ongoing trial. 35 patients had a colorectal cancer, 5 of these had prior cholecystectomy. No patient had elevated CCK-8 plasma levels. Gastrin levels were slightly elevated in 2 patients. There was no correlation between large bowel carcinoma and CCK-8 and gastrin levels. Elevated CCK-8 levels following cholecystectomy occur neither immediately after surgery nor on a long-term basis. Immunohistochemical studies in patients with colorectal cancer showed no CCK receptors in the normal colonic or tumor tissue. These findings are contrary to gastrin receptor data.
Résumé
L'influence élevée de cancer du colon après cholécystectomie a été longtemps un sujet de controverse. Le mécanisme pathogénique de cette entité cependant est encore obscure. De mombreux auteurs ont montré une corrélation entre les taux de cholécystokinine (CCK) et gastrine et la survenue de cancer colorectaux. A l'heure actuelle aucun fait précis n'est disponible sur l'impact potentiel de la cholécystectomie sur les altérations du taux de CCK. De plus aucune travail n'a encore été publié sur les récepteurs CCK. Nous avons étudié le rôle des taux plasmatiques de CCK-8 et de gastrine chez les patients avec une cholécystectomie antérieure et le taux de récepteurs CCK chez les patients avec un cancer colorectal. 125 malades on été entrés dans cette étude prospective. Parmi eux, 45 servaient de contrôle. 40 patients avaient une cholécystectomie première, 5 avaient subi une cholécystectomie durant l'essai. 35 patients avaient un cancer colo-rectal, 5 d'entre eux avaient une cholécystectomie antérieure. Aucun patient n'avaient des taux plasmatiques de CCK-8 élevés. Les taux de gastrine étaient légèrement élevés chez 2 patients. Il n'y avait pas de corrélation entre le cancer du colon et les taux de CCK-8 et de gastrine. Des taux élevés de CCK-8 suivant la cholécystectomie ne survenaient ni immédiatement après la chirurgie ni à long terme. Les études immunohistochimiques chez des patients avec cancer colorectal ne montraient pas de récepteurs à la CCK dans le colon normal ou le tissu tumoral. Ces découvertes sont contraires aux faits pour les récepteurs de gastrine.
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Rogy, M.A., Kovats, E., Koss, G. et al. CCK-8 and gastrin plasma levels in cholecystectomized and colorectal cancer patients. Int J Colorect Dis 8, 154–157 (1993). https://doi.org/10.1007/BF00341190
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DOI: https://doi.org/10.1007/BF00341190