Intrahepaticparasite infection and cholangiocarcinomas

在泰国东北部地区，肝吸虫寄生虫Opisthorchis viverrini(OV)是地方性疾病，经济困难的人食用含有寄生虫囊虫的生鱼，胆管细胞癌的发病率很高。先前，我们已经证明OV感染显着促进了仓鼠肝脏胆管细胞癌的发展，持续的炎症和再生性上皮细胞增生可能在OV感染的肝脏胆管细胞癌的发展中起重要作用。为了解韩国胆管细胞癌的发生与华支睾吸虫感染之间的关系，我们在釜山国立大学医学院寄生虫学系Soo Song教授的协助下，收集了在韩国釜山国立大学、高辛医学院和韩国釜山福音医院接受手术切除的440多例肝肿瘤的病理数据。其中，年龄在20岁以上的432例进行了分析。包括337名男性(平均年龄50.9岁(27-73岁))和95名女性(平均年龄51.2岁(21-76岁))。粪便检查和/或肝脏组织病理学检查发现49例男性(14.5%)和12例女性(12.6%)感染肝吸虫，88例男性和24例女性均为阴性。112例感染阴性病例中，肝细胞癌97例，胆管细胞癌14例，而61例感染阳性病例中，肝细胞癌32例，胆管细胞癌28例。华支睾吸虫感染阳性组与阴性组各型癌的发病率有显著差异(P&lt；0.001，Fischer精确分析)，表明华支睾吸虫感染也是胆管细胞癌发生的危险因素。

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.