Gut Liver.  2018 May;12(3):236-245. 10.5009/gnl17102.

Liver Fluke-Associated Biliary Tract Cancer

• Prueksapanich P
• Piyachaturawat P
• Aumpansub
• Ridtitid W
• Chaiteerakij R
• Rerknimitr R

• KMID: 2411668
• DOI: http://doi.org/10.5009/gnl17102

Abstract

Cholangiocarcinoma (CCA) is an aggressive cancer arising from epithelial cells of the bile duct. Most patients with CCA have an unresectable tumor at the time of diagnosis. In Western countries, the risk of CCA increases in patients with primary sclerosing cholangitis, whereas liver fluke infection appears to be the major risk factor for CCA in Asian countries. A diagnosis of liver fluke infection often relies on stool samples, including microscopic examination, polymerase chain reaction-based assays, and fluke antigen detection. Tests of serum, saliva and urine samples are also potentially diagnostic. The presence of liver fluke along with exogenous carcinogens magnifies the risk of CCA in people living in endemic areas. The "liver fluke-cholangiocarcinoma" carcinogenesis pathways consist of mechanical damage to the bile duct epithelium, immunopathologic and cellular reactions to the liver fluke's antigens and excretory/secretory products, liver fluke-induced changes in the biliary tract microbiome and the effects of repeated treatment for liver fluke. A vaccine and novel biomarkers are needed for the primary and secondary prevention of CCA in endemic areas. Importantly, climate change exerts an effect on vector-borne parasitic diseases, and awareness of liver fluke should be enhanced in potentially migrated habitat areas.

Keyword

Cholangiocarcinoma; Opisthorchiasis; Clonorchiasis

MeSH Terms

Asian Continental Ancestry Group
Bile Ducts
Biliary Tract Neoplasms*
Biliary Tract*
Biomarkers
Carcinogenesis
Carcinogens
Cholangiocarcinoma
Cholangitis, Sclerosing
Climate Change
Clonorchiasis
Diagnosis
Ecosystem
Epithelial Cells
Epithelium
Fasciola hepatica
Humans
Liver*
Microbiota
Opisthorchiasis
Parasitic Diseases
Risk Factors
Saliva
Secondary Prevention
Trematoda
Biomarkers
Carcinogens