RESEARCH ARTICLE The role of H. pylori infection in gall bladder cancer: clinicopathological study Ehsan Hassan Hassan 1 & Shawkat S. Gerges 2 & Kamal A. El-Atrebi 3 & Hala T. El-Bassyouni 4 Received: 13 January 2015 /Accepted: 8 April 2015 # International Society of Oncology and BioMarkers (ISOBM) 2015 Abstract Recent work demonstrated the presence of Helicobacter pylori (H. pylori) in the bile and gallbladder of more than 75 % of patients with gallbladder cancer and more than 50 % of patients with chronic cholecystitis. The aim of the work was to determine the prevalence of H. pylori in the gallbladder of patients operated on for chronic cholecystitis and relating their presence to the precancerous histological changes. In our study, fifty patients were operated on for chronic cholecystitis. The patients were subdivided into two groups (each includes 25 patients): H. pylori-positive group, who had H. pylori in their gallbladder mucosa detected by Giemsa stain, and H. pylori-negative group. The histological findings (mucosal erosions, atrophy, metaplasia, dysplasia, lymphoid infiltration, musculosa hypertrophy, and fibrosis) were compared between the two groups. Comparing the his- tological findings of the H. pylori-infected gallbladders with the non-infected ones, the gallbladders with mucosal hyper- plasia, metaplasia/dysplasia, and lymphoid infiltration showed statistically significant differences, with a P value of 0.028, 0.049, and 0.022, respectively. On the other hand, no statistically significant differences were detected between the two groups in the degree of mucosal erosions (P =0.299), atrophy, musculosa hypertrophy (P =1.000), and fibrosis (P =1.000). These results highlight the role of H. pylori infec- tion in aggravating the mucosal lesions (mucosal hyperplasia, metaplasia, and lymphoid infiltration) of the gallbladder that is considered potentially precancerous. Keywords Helicobacter pylori . Chronic cholecystitis . Gallbladder mucosa Introduction Recently, inflammation was distinguished as a hallmark of cancer. Increasing proof demonstrated that a large number of tumors originate from sites of chronic inflammation, which supports the perspective that chronic inflammation can incline to cancer [1]. Chronic inflammation plays a serious role in evoking cancer development in the gallbladder. Gallbladder cancer (GBC) is the most frequent malignancy of the biliary tract and the fifth most common gastrointestinal cancer world- wide. GBC has a high incidence in the sixth and seventh decades of life, and women are affected two to six times more often than men [2]. Chronic inflammation increases the fre- quency of expression of cancers [3]. A history suggestive of chronic cholecystitis is present in approximately 50 % of the GBC patients [4]. The percentage of patients having gallblad- der cancer after cholecystectomy for assumed gallbladder stone disease is 0.5 – 1.5 % [ 5 ]. The existence of Helicobacter pylori and Helicobacter bilis both in the bile and gallbladder was confirmed in more than 75 % of patients with gallbladder cancer and more than 50 % of patients with chronic cholecystitis undergoing surgery [6]. H. pylori-posi- tive patients are closely associated with chronic gastritis, pep- tic ulcers, gastric carcinoma, and malignant lymphoma of gas- tric mucosa-associated lymphoid tissues (MALToma) [7, 8]. * Hala T. El-Bassyouni halabassyouni@yahoo.com 1 Pathology Department, National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt 2 Surgery Department, National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt 3 General Medicine and Hepatology Department, National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt 4 Clinical Genetics Department, National Research Center, El-Tahreer Street, Cairo, Egypt Tumor Biol. DOI 10.1007/s13277-015-3444-9