Nakashima T, Okuda K, Kojiro M, Sakamoto K, Kubo Y
Cancer. 1975 Oct;36(4):1483-9. doi: 10.1002/1097-0142(197510)36:4<1483::aid-cncr2820360441>3.0.co;2-9.
The etiologic relationship of parasitic liver disease to primary liver cancer has long been debated. For this reason, a review of 4611 necropsies was carried out to determine the frequency with which hepatocellular carcinoma occurred in association with schistosomiasis. Of 227 cases of hepatocellular carcinoma, 24 (10.6%) were associated with schistosomiasis japonica. This was significantly higher than the incidence of this carcinoma without schistosomiasis (2.78%). The majority of the 24 cases exhibited the features of a mixed macronodular and micronodular cirrhosis (Gall's posthepatitic cirrhosis); this was super-imposed upon and caused a masking of schistosomiasis fibrosis. By radioimmunoassay hepatitis B antigen was positive in 27% of these cases. A review of the literature indicated that chronic schistosomiasis, on its own, is unlikely to be the cause of primary liver cell carcinoma. Histologic features resembling post-hepatitic cirrhosis combined with a high frequency of hepatitis B antigen suggest that viral hepatitis rather than S. japonicum is the more likely etiologic factor involved, or has a synergistic effect on carcinogenesis.
寄生虫性肝病与原发性肝癌之间的病因学关系长期以来一直存在争议。因此，对4611例尸检进行了回顾性研究，以确定肝细胞癌与血吸虫病同时发生的频率。在227例肝细胞癌病例中，24例（10.6%）与日本血吸虫病有关。这一比例显著高于无血吸虫病时该癌症的发病率（2.78%）。24例中的大多数表现为混合性大结节和小结节性肝硬化（加尔氏肝炎后肝硬化）的特征；这种肝硬化叠加在血吸虫病纤维化之上并掩盖了它。通过放射免疫测定，这些病例中有27%的乙肝抗原呈阳性。文献回顾表明，单纯的慢性血吸虫病不太可能是原发性肝细胞癌的病因。类似于肝炎后肝硬化的组织学特征以及高频率的乙肝抗原表明，病毒性肝炎而非日本血吸虫更可能是相关的病因因素，或者对致癌作用具有协同效应。
