title: Analysis of Carcinogenic Heavy Metals in Gallstones and its Role in Gallbladder Carcinogenesis.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Bio-Medical Laboratory Science & Management, Vidyasagar University, Midnapore, 721102, India.|Department of Pathology, Bankura Sammilani Medical College, Bankura, 722101, India.
authors.forename: Bikash
authors.initials: B
authors.lastname: Mondal
authors.affiliation: Department of General Surgery, Bankura Sammilani Medical College, Bankura, 722101, India.
authors.forename: Dhrubajyoti
authors.initials: D
authors.lastname: Maulik
authors.affiliation: School of Medical Science and Technology, Indian Institute of Technology, Kharagpur, 721302, India.
authors.forename: Mousumi
authors.initials: M
authors.lastname: Mandal
authors.affiliation: Department of Community Medicine, Bankura Sammilani Medical College, Bankura, 722101, India.
authors.forename: Gautam Narayan
authors.initials: GN
authors.lastname: Sarkar
authors.affiliation: Department of Pathology, Bankura Sammilani Medical College, Bankura, 722101, India.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Sengupta
authors.affiliation: Department of Bio-Medical Laboratory Science & Management, Vidyasagar University, Midnapore, 721102, India. debidas_ghosh@yahoo.co.in.
authors.forename: Debidas
authors.initials: D
authors.lastname: Ghosh
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005706:Gallbladder Neoplasms / Q000209:etiology* / Q000473:pathology; D006801:Humans; D008297:Male; D019216:Metals, Heavy / Q000009:adverse effects*; D008875:Middle Aged; D012307:Risk Factors
chemical_list: D019216:Metals, Heavy
keywords: Carcinogenic heavy metals; Chronic cholecystitis; Dense deposits; Gallbladder pre-malignancy and malignancy; Gallstones