Liver fluke-associated cholangiocarcinoma
Article first published online: 29 NOV 2002
© 2002 British Journal of Surgery Society Ltd
British Journal of Surgery
Volume 89, Issue 8, pages 962–970, August 2002
How to Cite
Watanapa, P. and Watanapa, W. B. (2002), Liver fluke-associated cholangiocarcinoma. Br J Surg, 89: 962–970. doi: 10.1046/j.1365-2168.2002.02143.x
- Issue published online: 29 NOV 2002
- Article first published online: 29 NOV 2002
- Manuscript Accepted: 20 MAR 2002
Infection with liver flukes has been reported to be associated with bile duct malignancy.
The review is based on a literature search (Medline) and, in some cases, direct contact with authors or principal investigators.
A large body of evidence indicates that Opisthorchis viverrini is a definite cause of human cholangiocarcinoma, whereas Clonorchis sinensis is a probable cause. The evidence regarding Opisthorchis felineus is insufficient to assess its role in carcinogenesis. Possible mechanisms of carcinogenesis include chronic irritation, nitric oxide formation, intrinsic nitrosation and activation of drug-metabolizing enzymes. Early detection of bile duct malignancy is difficult and not clinically available at present, although cholangiocarcinoma-associated soluble antigen has been reported in an experimental study to be a useful early marker of cancer development. Long-term survival after surgical treatment of liver fluke-associated cancer is similar to that reported in patients without liver fluke infestation.
Liver fluke-associated cholangiocarcinoma is still a health problem in developing countries. Mechanisms of carcinogenesis should be explored further in order to reduce the impact of this disease. © 2002 British Journal of Surgery Society Ltd