Serum Aflatoxin B1-Lysine Adduct Concentration and Gallbladder Cancer: A Case-Control Study

Aflatoxin B1 (AFB1) may be associated with not only developing liver cancer but also gallbladder cancer (GBC). We aimed to investigate whether serum AFB1 level of GBC patients is higher than chronic cholecystitis (CC) patients or healthy subjects (HS). Serum was collected from 45 GBC patients (18 men, 27 women), 57 CC patients (22 men, 35 women), and 55 HS (20 men, 35 women) from May 2021 to February 2024. Serum AFB1-lysine adduct level was measured using a commercial ELISA kit. Detection frequency (≥0.1 ng/ml), median and mean levels of serum AFB1-lysine adduct were compared among three groups. The detection rate was 71% (35/45) in GBC patients, 39% (22/57) in CC, and 7% (4/55) in HS (p < 0.001). Age- and gender-adjusted odds ratios of AFB1 detection in GBC patients were 4.1 and 16.8 times higher than in CC patients and HS, respectively. The median levels were 5.0 ng/mL in GBC patients and < 0.1 ng/mL in CC patients and HS. The mean level in GBC patients (7.9 ± 8.4 ng/mL) was significantly higher than that in CC patients (2.7 ± 4.5 ng/mL) or HS (0.3 ± 1.1 ng/mL). Our findings show direct evidence that AFB1 exposure may be associated with risk of developing GBC in India.