Cholecystolithiasis is associated with Clonorchis sinensis infection.
BACKGROUND
The objective of this study was to analyze gallbladder stones for direct evidence of a relationship between Clonorchis sinensis infection and gallbladder stones formation.


METHODS
We investigated one hundred eighty-three gallbladder stones for the presence of Clonorchis sinensis eggs using microscopy, and analyzed their composition using Fourier transform infrared spectroscopy. We confirmed the presence of Clonorchis sinensis eggs in the gallbladder stones using real-time fluorescent PCR and scanning electron microscopy.


RESULTS
Clonorchis sinensis eggs were detected in 122 of 183 gallbladder stones based on morphologic characteristics and results from real-time fluorescent PCR. The proportion of pigment stones, cholesterol stones and mixed gallstones in the egg-positive stones was 79.5% (97/122), 3.3% (4/122) and 17.2% (21/122), respectively, while 29.5% (18/61), 31.1% (19/61) and 39.3% (24/61) in the egg-negative stones. The proportion of pigment stone in the Clonorchis sinensis egg-positive stones was higher than in egg-negative stones (P<0.0001). In the 30 egg-positive stones examined by scanning electron microscopy, dozens or even hundreds of Clonorchis sinensis eggs were visible (×400) showing a distinct morphology. Many eggs were wrapped with surrounding particles, and in some, muskmelon wrinkles was seen on the surface of the eggs. Also visible were pieces of texture shed from some of the eggs. Some eggs were depressed or without operculum while most eggs were adhered to or wrapped with amorphous particles or mucoid matter (×3000).


CONCLUSIONS
Clonorchis sinensis eggs were detected in the gallbladder stones which suggests an association between Clonorchis sinensis infection and gallbladder stones formation, especially pigment stones.
Laboratory of Gallbladder Diseases, Institute of Gallbladder Disease of Panyu, Guangzhou, People's Republic of China. fqj1958@163.com
Tie
T
Qiao
Rui-hong
RH
Ma
Xiao-bing
XB
Luo
Zhen-liang
ZL
Luo
Pei-ming
PM
Zheng
D000328:Adult; D000818:Animals; D002681:China; D041761:Cholecystolithiasis / Q000150:complications / Q000209:etiology* / Q000469:parasitology*; D003003:Clonorchiasis / Q000150:complications*; D003004:Clonorchis sinensis / Q000378:metabolism*; D005260:Female; D005456:Fluorescent Dyes / Q000494:pharmacology; D042882:Gallstones / Q000473:pathology; D006801:Humans; D008297:Male; D008855:Microscopy, Electron, Scanning / Q000379:methods; D008875:Middle Aged; D016133:Polymerase Chain Reaction / Q000379:methods; D017550:Spectroscopy, Fourier Transform Infrared / Q000379:methods
D005456:Fluorescent Dyes