Helicobacter pylori as an Etiologic Factor in Primary Lung Carcinoma

Objective: Although the importance of environmental and occu- pational exposure to carcinogenic agents in pulmonary carcinoma is well known, some other factors, such as familial predisposition, genetic abnormalities, and recently, the presence of Helicobacter pylori infection, are being disputed. This study focused on the re- lationship between pulmonary carcinoma and H. pylori infection. Methods: In total, 48 histologically verified and operated pa- tients with pulmonary carcinoma, including 38 males and 10 females, were included; 22 of the cases were of squamous cell car- cinomas and 26 were adenocarcinomas. The control group com- posed of 20 patients who underwent pulmonary operation for causes other than lung cancer. Adjacent non-neoplastic paren- chymal and bronchial tissue examples were stained using the Gi- emsa stain in carcinoma cases. The pulmonary tissue-contained bronchial sections were stained in control cases. The bronchial epithelia and lumina in the Giemsa stained slides were examined for H. pylori bacilli. Results: H. pylori was found in 2 of 48 carcinoma cases. The histopathological diagnosis of these 2 cases was squamous cell carcinoma. But there wasn't any case stained for H.pylori in the control group. Conclusion: The relationship between pulmonary carcinoma and H. pylori infection had been researched through serological studies; however, conflicting evidences have been obtained. The bacterium is transmitted to the lungs via seeding and inhalation was reported to be effective directly. Chronic H. pylori infection leads to bron- chial epithelial proliferation via increased gastrin level and cyclo- oxygenase-2. Moreover, it contributes to pulmonary carcinogen- esis. In conclusion, an association between H. pylori infection and pulmonary carcinoma may be revealed by variable studies, and the underlying mechanisms can be understood.

Primer Akciğer Kanserinde Etyolojik Faktör Olarak Helicobacter Pylori

Amaç: Akciğer karsinomlarında mesleki ve çevresel karsinojen- lere maruziyet önemli olmakla birlikte, ailevi yatkınlık, genetik anormallikler ve son olarak Helicobacter pylori infeksiyonu ilişkisi gibi bazı diğer faktörler sorgulanmaktadır. Bu çalışmada Helico- bacter pylori ve akciğer karsinom ilişkisi üzerinde durulmuştur. Yöntemler: Otuz sekiz erkek ve 10 kadından oluşan opere edi- lerek histolojik verifikasyonu sağlanan 48 akciğer karsinomu ol- gusu çalışmaya alınmıştır. Bunların 22’si skuamöz hücreli karsi- nom 26’sı adenokarsinomdur. Akciğer karsinomu dışı nedenlerle pulmoner operasyon geçiren 20 olgu kontrol grubunu oluştur- maktadır. Karsinom olgularında tümöre bitişik nonneoplastik parankimal ve bronşial doku örnekleri Giemsa ile boyanmıştır. Kontrol grubunda ise bronş kesiti içeren pulmoner doku örnek- leri boyamaya alınmıştır. Giemsa boyalı kesitlerde bronş epiteli ve lümeninde basil aranmıştır. Bulgular: Helicobacter pylori 48 karsinom olgusunun ikisinde saptanmıştır. Bu iki olguda histopatolojik tanı skuamöz hücreli karsinomdur. Kontrol grubunda ise basil saptanmamıştır. Sonuç: Serolojik çalışmalarla akciğer kanseri ve Helicobacter pylo- ri arasında ilişki ortaya konmaya çalışılmakla birlikte çelişkili so- nuçlar elde edilmiştir. Ekilme ya da inhalasyon ile akciğere ulaşan bakterinin direkt olarak etkili olduğu söylenmektedir. Kronik Helicobacter pylori enfeksiyonunun gastrin ve COX-2 seviyelerini arttırarak bronş epitel proliferasyonu ve bunun ötesinde pulmo- ner karsinogeneze katkıda bulunduğu öne sürülmektedir. Sonuç olarak Helicobacter pylori infeksiyonu ve akciğer karsinomu ara- sındaki ilişki farklı tipteki çalışmalarla ortaya konabilir ve altta yatan mekanizmalar açığa çıkarılabilir.

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