Analysis of Carcinogenic Heavy Metals in Gallstones and its Role in Gallbladder Carcinogenesis
https://pubmed.ncbi.nlm.nih.gov/27888389/
- December 2017
- Journal of Gastrointestinal Cancer 48(4)
- DOI: 10.1007/s12029-016-9898-1
Bikash Mondal
Dhrubajyoti Maulik
Mousumi Mandal
Abstract
Purpose: Gallstone is a high-risk factor for gallbladder pre-malignancy or malignancy (GB PM-M) but which substances of gallstones definitely assist to turn out in to GB PM-M, remains unclear. This study aimed to find out the presence of carcinogenic heavy metals in gallstones and to explore the aetiopathogenesis of gallbladder pre-malignancy and malignancy.
Methods: Presence of elements in gallstones was detected by energy dispersive X-ray spectroscopy (EDS) with scanning electron microscopy (SEM) and then level of carcinogenic heavy metals was estimated in gallstones using atomic absorption spectroscopy (AAS). The experiment was carried out in gallstone samples of 46 patients with gallbladder pre-malignant and malignant condition (PM-M group) and 65 sex and age-matched patients with chronic cholecystitis (C-C group). Gallstones were also classified in to three types such as cholesterol stone, mixed stone, and black pigment stone.
Results: EDS analysis detected presence of mercury, lead, and cobalt elements in all types of gallstones of both PM-M and C-C groups. AAS analysis revealed significantly higher amount of mercury (p < 0.001), lead (p < 0.0001), cobalt (p < 0.01), and cadmium (p < 0.01) in the gallstones of PM-M than C-C groups. The presence of these heavy metals also varied among stone types of both groups. EDS phase analysis showed 'dense deposits' of these metals in gallstones.
Conclusions: Presence of significantly higher amount of mercury, lead, cobalt, and cadmium in gallstones may play a pivotal role as risk factors in the development of gallbladder malignancy or pre-malignancy. 'Dense deposits' of these metals in the gallstones which is the first observation, may act as crucial doses of carcinogens.
Keywords: Carcinogenic heavy metals; Chronic cholecystitis; Dense deposits; Gallbladder pre-malignancy and malignancy; Gallstones.
Representative of three types of gallstones (GS) a cholesterol GS, b mixed GS, c black pigment GS
SEM-EDS analysis of gallstones: (ai) Different EDS spots of cholesterol GS and (aii) elemental distribution of EDS spot 1 depicting existance of Pb and Co elements, (bi) different EDS spots of mixed GS and (bii) elemental distribution of spot 1 depicting a large peak of Hg including various elements, (ci) a large EDS area of black GS and (cii) its elemental distribution indicating existance of Pb elements along with other elements
OBS: Note also aluminum.
Box plots depicting the concentration of heavy metals in different types of gallstones causing chronic cholecystitis (C-C group), and pre-malignant and malignant condition of gallbladder (PM-M group). Different types of gallstones means cholesterol gallstones (CHOLS), mixed gallstones (MIXED), and pigment black gallstones (BLACK). ‘Overall’ indicates all types of gallstones in together. Each graph represents the individual element concentration: a mercury (Hg), b lead (Pb), c arsenic (As), d chromium (Cr), e cobalt (Co), and f cadmium (Cd). Statistical significance between study groups has been symbolized as following: *p < 0.05, **p < 0.01, ***p < 0.001, and ****p < 0.0001
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