Gallbladder mucosa ornithine decarboxylase activity is increased in patients with anomalous arrangement of the pancreaticobiliary duct.

Ornithine decarboxylase (ODC) activity, which seems to increase in premalignant lesions, was studied in gallbladder mucosa from 32 patients with or without anomalous arrangement of the pancreaticobiliary duct (AAPBD). Mucosal ODC activity was significantly increased in 17 patients with AAPBD compared with 15 control subjects with normal biliary anatomy. Among the 17 patients with AAPBD, ODC activity was significantly increased in 7 in whom the major pancreatic duct joined the common bile duct (P-C type) compared with 8 in whom the common bile duct joined the pancreatic duct (C-P type). The increased ODC activity in gallbladder mucosa suggests that patients with the P-C type of AAPBD may have an increased risk of gallbladder cancer. These results are consistent with recent clinicopathologic studies of AAPBD that have demonstrated an association between AAPBD and biliary tract malignancy. Determination of the mechanism that induces mucosal ODC activity may provide a clue to the pathogenesis of gallbladder carcinoma in patients with AAPBD.