Routes and types of microbial infection in the pathology of pancreatic adenocarcinoma

Abstract

Introduction/Objective. Pancreatic cancer may be accompanied by infections caused by various microorganisms. It is uncertain wheatear pancreatic infection precedes the development of cancer or vice versa. The aim of this study is to analyze routes of infections from the duodenum through the pancreatic duct to determine what types of microorganisms can get through this duct into the pancreas and nearby tissue. Methods. In patients subjected to cephalic duodenopancreatectomy (Whipple procedure) due to adenocarcinoma of the ampulla of Vater, the duodenum or head of the pancreas, swabs from duodenal mucosa, pancreatic duct, and pancreatic tissue at the line of the resection were taken. Microscopic slides were prepared directly from the patients? specimens as well as from colonies on culture plates, and both were Gram stained. Results. Candida was present in all three types of swabs (duodenum, pancreatic duct, and tissue), while bacteria, depending on the species (Pseudomonas aeruginosa, ?-hemolytic Streptococcus, coagulasenegative Staphylococcus, Enterococcus spp., Serratia spp.), were present in pancreatic duct or tissue, but not in the duodenum. Conclusion. There is a connection between the presence of microorganisms and pathology of the pancreatic adenocarcinoma. Results show that Candida infection originates from the duodenum, while bacterial infections originate directly from blood or tissue injuries.