Intrahepaticparasite infection and cholangiocarcinomas

泰国东北地区是肝吸虫（Opisthorchis viverrini， OV）的流行地，经济条件较差的人食用含有囊蚴寄生虫的生鱼，胆管细胞癌的发病率很高。先前我们已经证明OV感染显著促进仓鼠肝脏胆管细胞癌的发展，并且延长炎症和再生上皮增生可能在OV感染肝脏胆管细胞癌的发展中起重要作用。目前的调查是为了了解在韩国，胆管细胞癌的发展与华支睾吸虫感染之间是否存在任何关联。在釜山国立大学医学院寄生虫学教授Soo Song的协助下，我们收集了在韩国釜山国立大学、Kosin医学院和福音医院手术切除的440多个肝脏肿瘤的病理数据。其中，年龄在20岁以上的432例进行了分析。其中男性337人（平均年龄50.9岁（27-73岁）），女性95人（平均年龄51.2岁（21-76岁））。男性49例（14.5%），女性12例（12.6%），通过粪便检查和肝脏组织病理学检查发现肝吸虫感染，男性88例，女性24例，两项检查均阴性。112例感染阴性患者中，肝细胞癌97例，胆管细胞癌14例；61例感染阳性患者中，肝细胞癌32例，胆管细胞癌28例。感染阳性组和阴性组各类型癌的发生率有显著差异（P<0.001， Fischer精确分析）。因此，这些结果清楚地表明，感染华支睾吸虫也是胆管细胞癌发展的一个危险因素。

The northeast area of Thailand where the liver fluke parasite Opisthorchis viverrini (OV) is endemic and economically disadvantaged people eat raw fish harboring parasite metacercariae has a high incidence of cholangiocellular cancer. Previously we have demonstrated that OV infestation significantly enhances development of cholangiocellular carcinoma in hamster livers and that prolonged inflammation and regenerative epithelial hyperplasia may play important roles in development of cholangiocellular carcinomas in OV infested livers. The present investigation was performed to see whether there is any association between development of cholangiocellular carcinomas and infection with Clonorchis sinensis in Korea.With assistance from Professor Soo Song, Department of Parasitology, College of Medicine Pusan National university, we collected pathological data on over 440 liver tumors surgically removed at Pusan National University and Kosin Medical College and Gospel Hospital in Pusan, Korea. Of these, 432 cases aged more than 20 years old were subjected to analysis. They comprised 337 males (mean age 50.9 years old (27-73 yrs)) and 95 females (mean age 51.2 years old (21-76 yrs)). Forty nine males (14.5%) and 12 females (12.6%) were revealed to be infected with liver flukes by stool examination and/or histopathology of the livers and 88 males and 24 females were negative for both examinations. Hepatocellular carcinomas and cholangiocellular carcinomas were present in 97 cases and 14 cases, respectively among the 112 infection-negative cases, whereas they were found in 32 and 28, respectively, of the 61 infection-positive cases. A significant difference (P<0.001, Fischer exact analysis) in the incidences of each type of carcinoma was evident between the infection-positive and negative groups.Thus, these results clearly demonstrate that infection with Clonorchis sinensis is also a risk factor for development of cholangiocellular carcinomas.