• 1.解放軍309醫(yī)院普外科（北京100091）;;
  • 2.解放軍總醫(yī)院普外科（北京100853）;;
  • 3.解放軍309醫(yī)院肝膽外科;

目的  探討膽囊切除術(shù)對大腸癌發(fā)生的影響及作用機(jī)理。
方法  膽囊切除術(shù)后以二甲基肼誘發(fā)小鼠大腸癌，觀察大腸腫瘤發(fā)生情況； 流式細(xì)胞術(shù)測定大腸粘膜上皮細(xì)胞S期百分比； 高效液相色譜儀檢測手術(shù)前后鼠糞膽酸、鵝脫氧膽酸、脫氧膽酸和石膽酸含量。
結(jié)果  實(shí)驗(yàn)組荷結(jié)節(jié)鼠大腸平均荷結(jié)節(jié)數(shù)、受檢鼠大腸腺瘤發(fā)生率及S期百分比均明顯高于對照組（P＜0.05）； 膽囊切除術(shù)后鼠糞石膽酸含量較術(shù)前和對照組明顯增加（P=0.00）。
結(jié)論  膽囊切除后二甲基肼誘發(fā)的小鼠大腸腫瘤發(fā)生數(shù)量有所增加，并且大腸粘膜上皮細(xì)胞增殖旺盛，提示膽囊切除術(shù)對二甲基肼誘發(fā)小鼠大腸腫瘤有協(xié)同促進(jìn)作用，可能與術(shù)后腸道內(nèi)次級膽汁酸石膽酸含量增加有關(guān)。

引用本文： 楊波,蔣彥永,蕭蔭祺,蒲永東. 膽囊切除術(shù)對二甲基肼誘發(fā)小鼠大腸癌的影響. 中國普外基礎(chǔ)與臨床雜志, 2002, 9(1): 19-22. doi: 復(fù)制

版權(quán)信息： ?四川大學(xué)華西醫(yī)院華西期刊社《中國普外基礎(chǔ)與臨床雜志》版權(quán)所有，未經(jīng)授權(quán)不得轉(zhuǎn)載、改編

1. Alley PG, Lee SP. The increased risk of proximal colonic cancer after cholecystectomy [Ｊ]. Dis Colon Rectum， 1983; 26(8)∶522.
2. Adami HO, Krusemo UB, Meirik O. Unaltered risk of colorectal cancer within 14-17 years of cholecystectomy: updating of a populationbased cohort study [Ｊ]. Br J Surg， 1987; 74(8)∶675.
3. 許紅兵，蕭蔭琪，錢志平,等. 膽囊切除術(shù)與大腸癌關(guān)系的探討 [Ｊ].中國肛腸病雜志，1989； 9(2)∶25.
4. Lingeman CH, Garner FM. Comparative study of intestinal adenocarcinomas of animals and man [Ｊ]. J Natl Cancer Inst， 1972; 48(2)∶325.
5. Roges AE. Contribution of laboratory animal studies of colon carcinogenesis. In: Masteromarino AJ. Large bowel cancer [M]. New York： Praeger Published, 1985∶ 1-33.
6. Kuniyasu T, Tanaka T, Shima H,et al. Enhancing effect of cholecystectomy on colon carcinogenesis induced by methylazoxymethanol acetate in hamsters [Ｊ]. Dis Colon Rectum, 1986; 29(8)∶492.
7. Fazio VW. Current therapy in colon and rectal surgery [M]. Philadelphia: B.C. Decker Incorporated, 1990∶ 227.
8. PrestonMartin S, Pike MC, Ross RK, et al. Increased cell division as a cause of human cancer [Ｊ]. Cancer Res, 1990; 50(12)∶7415.
9. Vernick LJ,Kuller LH.Cholecystectomy and right side colon cancer: an epidemiological study [Ｊ].Lancet, 1981; 2(8243)∶381.
10. Markman M. Cholecystectomy and carcinoma of the colon [Ｊ]. Lancet, 1982; 2(8288)∶47.
11. Turunen MJ, Kivilaakso EO. Increased risk of colorectal cancer after cholecystectomy [Ｊ]. Ann Surg, 1981; 194(5)∶639.
12. Nielsen GP, Theldors A, Tulinius H, et al. Cholecystectomy and colorectal carcinoma: a totalpopulation historical prospective study [Ｊ]. Am J Gastroenterol, 1991; 86(10)∶1486.
13. Ekbom A, Yuen J, Adami HO, et al. Cholecystectomy and colorectal cancer [Ｊ]. Gastroenterology, 1993; 105(1)∶142.
14. Narisaw T,Magadia NE,Weisburger JH,et al.Promoting effect of bile acids on colon carcinogenesis after intrarectal instillation of NmethylNnitroNnitnosoguanidine in rats [Ｊ]. J Natl Cancer Inst,1974; 53(4)∶1093.
15. Reddy BS, Narasswa J, Wesburger JH, et al. Brief communication: promoting effect of sodium deoxycholate on colon adenocarcinomas in germ free rats [Ｊ]. J Natl Cancer Inst,1976; 56(2)∶441.
16. Zusman I, Zimber A. Ultrastructural changes in rat colorectal epithelium and tumors after treatment with NmethylNnitroNnitrosoguanidine and secondary bile acids [Ｊ]. Acta Anat, 1991; 141(1)∶282.
17. Morvay K,Szentleleki K,Torok G,et al. Effect of change of fecal bile acid excretion achieved by operative procedures on 1,2dimethylhydrazineinduced colon cancer in rats [Ｊ]. Dis Colon Rectum,1989; 32(10)∶860.
18. Malagelada JR, Go VLW, Summerskill WHJ, et al. Bile acid secretion and biliary bile acid composition altered by cholecystectomy [Ｊ]. Dig Dis Sci, 1973; 18(5)∶455.
19. Roda E, Aldini R, Mazzella G, et al. Enteroheptic circulating of bile acids after cholecystectomy [Ｊ]. Gut, 1978; 19(5)∶640.
20. Zuccato E, Ventari M, Leo GD, et al. Role of bile acids and metabolic activity of colonic bacteria in increased risk of colon cancer after cholecystectomy [Ｊ]. Dig Dis Sci, 1993; 38(3)∶514.
21. Narisawa T, Sano M, Suto M, et al. The correlation between cholecystectomy and fecal bile acids, and large bowel cancer induced with 1,2dimethylhydrazine in mice [Ｊ]. Dis Colon Rectum, 1985; 28(1)∶27.
  1. 1. Alley PG, Lee SP. The increased risk of proximal colonic cancer after cholecystectomy [Ｊ]. Dis Colon Rectum， 1983; 26(8)∶522.
  2. 2. Adami HO, Krusemo UB, Meirik O. Unaltered risk of colorectal cancer within 14-17 years of cholecystectomy: updating of a populationbased cohort study [Ｊ]. Br J Surg， 1987; 74(8)∶675.
  3. 3. 許紅兵，蕭蔭琪，錢志平,等. 膽囊切除術(shù)與大腸癌關(guān)系的探討 [Ｊ].中國肛腸病雜志，1989； 9(2)∶25.
  4. 4. Lingeman CH, Garner FM. Comparative study of intestinal adenocarcinomas of animals and man [Ｊ]. J Natl Cancer Inst， 1972; 48(2)∶325.
  5. 5. Roges AE. Contribution of laboratory animal studies of colon carcinogenesis. In: Masteromarino AJ. Large bowel cancer [M]. New York： Praeger Published, 1985∶ 1-33.
  6. 6. Kuniyasu T, Tanaka T, Shima H,et al. Enhancing effect of cholecystectomy on colon carcinogenesis induced by methylazoxymethanol acetate in hamsters [Ｊ]. Dis Colon Rectum, 1986; 29(8)∶492.
  7. 7. Fazio VW. Current therapy in colon and rectal surgery [M]. Philadelphia: B.C. Decker Incorporated, 1990∶ 227.
  8. 8. PrestonMartin S, Pike MC, Ross RK, et al. Increased cell division as a cause of human cancer [Ｊ]. Cancer Res, 1990; 50(12)∶7415.
  9. 9. Vernick LJ,Kuller LH.Cholecystectomy and right side colon cancer: an epidemiological study [Ｊ].Lancet, 1981; 2(8243)∶381.
  10. 10. Markman M. Cholecystectomy and carcinoma of the colon [Ｊ]. Lancet, 1982; 2(8288)∶47.
  11. 11. Turunen MJ, Kivilaakso EO. Increased risk of colorectal cancer after cholecystectomy [Ｊ]. Ann Surg, 1981; 194(5)∶639.
  12. 12. Nielsen GP, Theldors A, Tulinius H, et al. Cholecystectomy and colorectal carcinoma: a totalpopulation historical prospective study [Ｊ]. Am J Gastroenterol, 1991; 86(10)∶1486.
  13. 13. Ekbom A, Yuen J, Adami HO, et al. Cholecystectomy and colorectal cancer [Ｊ]. Gastroenterology, 1993; 105(1)∶142.
  14. 14. Narisaw T,Magadia NE,Weisburger JH,et al.Promoting effect of bile acids on colon carcinogenesis after intrarectal instillation of NmethylNnitroNnitnosoguanidine in rats [Ｊ]. J Natl Cancer Inst,1974; 53(4)∶1093.
  15. 15. Reddy BS, Narasswa J, Wesburger JH, et al. Brief communication: promoting effect of sodium deoxycholate on colon adenocarcinomas in germ free rats [Ｊ]. J Natl Cancer Inst,1976; 56(2)∶441.
  16. 16. Zusman I, Zimber A. Ultrastructural changes in rat colorectal epithelium and tumors after treatment with NmethylNnitroNnitrosoguanidine and secondary bile acids [Ｊ]. Acta Anat, 1991; 141(1)∶282.
  17. 17. Morvay K,Szentleleki K,Torok G,et al. Effect of change of fecal bile acid excretion achieved by operative procedures on 1,2dimethylhydrazineinduced colon cancer in rats [Ｊ]. Dis Colon Rectum,1989; 32(10)∶860.
  18. 18. Malagelada JR, Go VLW, Summerskill WHJ, et al. Bile acid secretion and biliary bile acid composition altered by cholecystectomy [Ｊ]. Dig Dis Sci, 1973; 18(5)∶455.
  19. 19. Roda E, Aldini R, Mazzella G, et al. Enteroheptic circulating of bile acids after cholecystectomy [Ｊ]. Gut, 1978; 19(5)∶640.
  20. 20. Zuccato E, Ventari M, Leo GD, et al. Role of bile acids and metabolic activity of colonic bacteria in increased risk of colon cancer after cholecystectomy [Ｊ]. Dig Dis Sci, 1993; 38(3)∶514.
  21. 21. Narisawa T, Sano M, Suto M, et al. The correlation between cholecystectomy and fecal bile acids, and large bowel cancer induced with 1,2dimethylhydrazine in mice [Ｊ]. Dis Colon Rectum, 1985; 28(1)∶27.