Aflatoxin exposure is associated with an increased risk of gallbladder cancer
Menée en France auprès de 100 témoins et 51 patients atteints d'un cancer des voies biliaires, cette étude analyse l'association entre une exposition alimentaire à l'aflatoxine et le risque de développer la maladie
Gall bladder cancer (GBC) is common among the socioeconomically deprived populations of certain geographical regions. Aflatoxin is a genotoxic hepatocarcinogen, which is recognized to have a role in the pathogenesis of hepatocellular carcinoma. However, the role of aflatoxin in the pathogenesis of GBC is largely unknown. We determined serum AFB1-Lys albumin adduct (AAA) levels as a marker of aflatoxin exposure in the patients with GBC and compared to those without GBC. The relationship of AAA levels to cytogenetic (TP53mutation&HER2/neu amplification) and radiological characteristics of the tumor was assessed. We included GBC cases (n = 51) and non-GBC controls (n = 100). Mean serum AAA levels were higher in the GBC group (n = 51) than those without GBC (n = 100) (26.1 ± 12.2 vs. 13.1 ± 11.9 ng/mL; p < .001). HER2/neu expression was associated with higher AAA levels compared to those with equivocal or negative expression (43.9 ± 3 vs. 28.6 ± 10 vs. 19.3 ± 7 ng/mL; p < .001). Older age (age >50 years) (odds ratio [OR] = 3.2 [CI: 1.3–8.2]; p = .013), positive Helicobacter pylori serology (OR = 5.1 [CI: 1.4–17.8]; p = .012), presence of GS (OR = 5 [CI: 1.5–16.9]; p = .009) and detectable AAA levels (OR = 6.8 [CI: 1.3–35.7]; p = .024) were independent risk factors for the presence of the GBC among all study subjects. Among patients harboring GS, older age (age >50 years) (OR = 4.5 [CI: 1.3–14.9]; p = .015), female gender (OR = 3.8 [CI: 1.2–12.5]; p = .027), presence of multiple GS (OR = 21.9 [CI: 4.8–100.4]; p < .001) and high serum AAA levels (OR = 5.3 [CI: 1.6–17.3]; p = .006) were independent risk factors for the presence of the GBC. Elderly age >50 years (OR = 2.6 [CI: 1.3–5.2]; p = .010) and frequent peanut consumption (OR = 2.3 [CI: 1.1–4.9]; p = .030) were independent risk factors for high serum AAA levels. The current study has implications for the prevention of GBC through the reduction of dietary aflatoxin exposure.