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

在泰国东北部地区，肝吸虫寄生虫Opisthorchis viverrini(OV)是地方性疾病，经济困难的人吃含有寄生虫的鱼的法鱼是胆管细胞癌的高发地区。本研究的目的是阐明胆管细胞癌与OV感染相关的组织病理学特征，确定食品中天然致癌物质的污染，评估与肝炎病毒的任何联系，并检验抗OV抗体对癌症发展的早期检测的预测价值。(1)在泰国东北部制备的Pla-ra鱼露中，通过高压液相或质量碎片法未发现明显的黄曲霉毒素B1、B2、G1和G2、杂色曲霉毒素、赭曲霉毒素、二甲基亚硝胺或二乙基亚硝胺污染。(2)从…93的HBs抗原分析中，未发现HVB感染与泰国东北部胆道癌发生的明显关联。(3)所有胆囊炎和/或胆管细胞癌患者均检测到抗OV抗体，滴度较高提示发生肿瘤的风险较高。(4)泰国东北部不同类型胆管细胞肿瘤的比例与日本患者相似，但髓质型低分化管状腺癌仅在泰国患者中发现。(5)胆管结扎可促进二甲基亚硝胺诱发的仓鼠胆管细胞癌的发生，模拟人重度OV感染所致的胆管梗阻和再生的上皮细胞增殖。(6)驱虫药吡喹酮可促进二乙基亚硝胺诱发的大鼠肝细胞癌的发生。然而，由于促进的有效剂量极高，预计对人类没有不良影响。总而言之，长期的炎症和再生性上皮增生似乎在泰国东北部胆管细胞癌的发展中起着重要作用。较少

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