Correlation between infection of Opisthorchis veverrini and the Development of hepatitis, liver cirrhosis and hepatic neoplasias.

在泰国东北地区，肝吸虫（Opisthorchis viverrini， OV）是一种地方性疾病，经济条件较差的人食用含有马尾蚴寄生虫的法律鱼，胆管细胞癌的发病率很高。本研究的目的是阐明与OV感染相关的胆管细胞癌的组织病理学特征，确定食品中的天然致癌物污染，评估其与肝炎病毒的关系，并检验抗OV抗体对早期检测癌症发展的预测价值。(1)高压液相色谱法和质量片段法均未发现黄曲霉毒素B1、B2、G1、G2、sterigmatocystin、赭曲霉毒素、二甲基亚硝胺、二乙基亚硝胺污染。(2)泰国东北部地区93例胆管细胞癌患者的HBs抗原分析显示，HVB感染与胆管癌的发生无相关性。(3)所有胆囊炎和/或胆管细胞癌患者均检测到抗ov抗体，抗体滴度越高，癌症发展风险越高。(4)泰国东北部不同胆管细胞肿瘤类型的比例与日本病例相似，但髓质型低分化管状腺癌仅在泰国患者中发现。胆管的炎症反应和肿瘤的早期发展明显与寄生虫有关。(5)胆管结扎促进二甲基亚硝胺引发的仓鼠胆管细胞癌的发展，类似于人类胆管因严重OV感染和再生上皮增生而阻塞。(6)吡喹酮对二乙基亚硝胺致大鼠肝癌有促进作用。然而，由于促进的有效剂量非常高，预计对人体没有不良影响。总之，在泰国东北部，持续的炎症和再生上皮增生似乎在胆管细胞癌的发展中起重要作用。少

The northeast area of Thailand where the liver fluke parasite Opisthorchis viverrini (OV) is endemic and economically disadvantaged people eat law fish harboring parasite matacercariae has a high incidence of cholangiocellular cancer. The present investigation was performed to clarify the histopathological characteristics of cholangiocellular carcinomas associated with OV infection, to determine natural carcinogen contamination in foodstuffs, to assess any association with hepatitis virus and to examine predictive value of anti-OV antibodies for early detection of cancer development.(1) No obvious aflatoxin B1, B2, G1 and G2, sterigmatocystin, ochratoxin, dimethylnitrosamine, or diethylnitrosamine contamination was found by high pressure liquid chromatography or the mass fragment method in the Pla-ra fish sauce prepared in the northeast Thailand.(2) No association of HVB infection with bile duct carcinoma development in northeastern Thailand was evident from HBs antigen analysis of 93 … More patients with cholangiocellular carcinomas.(3) Anti-OV antibody was detected in all patients with cholecystitis and/or cholangiocellular carcinomas, higher titers suggesting a higher risk of cancer development.(4) Proportions of different cholangiocellular tumor types in northeast Thailand were similar to those in Japanese cases except that the medullary type of poorly differentiated tubular adenocarcinoma was only found in Thai patients. Inflammatory reaction in the bile ducts and earlier development of tumors were apparent in association with parasites.(5) Bile duct ligation enhanced the development of dimethylnitrosamine-initiated hamster cholangiocellular carcinomas, mimicking bile duct obstruction by heavy OV infestation and regenerative epithelial proliferation in man.(6) Praziquantel, an anthelminthic agent was found to enhance diethylnitrosamine-initiated rat liver carcinogenesis. However, since the effective dose for promotion was extremely high, no adverse effect in man is expected.In conclusion, prolonged inflammation and regenerative epithelial hyperplasia appear to play important roles in development of cholangiocellular carcinomas in northeast Thailand. Less