Bile Acids in Patients

Bile acids are increasingly discussed in the genesis of colorectal carcinoma. In a pilot study we analysed bile acids in tumor tissue, tumor-free mucosa, serum, and feces o £ 6 patients with recta1 and 5 patients with colonic carcinoma, 5 patients dead from nongastroenterological diseases and two operated on for benign colonic stenosis seryed as controis for celorecta1 mucosa, 16 healthy persons as oontrols for feoes and serum. Bile aclds and their sulphates were determined after differential solvolysis by gas-liquid chromatography on QF-1 columns. Serum lithocholic acid was significantly (p< O, 05) elevated in all carcinoma patients. The feces howed a trend towards incTeased secondary bile acids, Tumor-free rnucosa ef patients with rectal carcinoma showed elevated unsulphated bile acids. sulphabed lithocholic acid <p<O, 05) and sulphated chenodeoxycholic acid (p<O, 025) were significantly decreased. In rectal carcinoma tissue total bile acids were elevated, cholic acid (p< O, Ol) and sulphated lithocholic acid decreased <p<O, 05). In nonaffected colonic mucosa of patients with colonic carcinoma tota1 bile acids were decreased, in colonic carcinoma tissue only traces of bile acids were found. Whether these changes are causes or rather consequences of colorecta1 tumors--e.g. turnor-induced stasis in the gut-and whether they may be useful foT diagnosis remains to be elucidated in further studies.