Parkin D M, Ohshima H, Srivatanakul P, Vatanasapt V
International Agency for Research on Cancer, Lyon, France.
Cancer Epidemiol Biomarkers Prev. 1993 Nov-Dec;2(6):537-44.
Cholangiocarcinoma is a relatively rare cancer; worldwide it accounts for an estimated 15% of liver cancers. In most areas, the etiology is rather obscure, and identified risk factors such as hepatolithiasis, inflammatory bowel disease, and exposure to Thorotrast can account for only a small proportion of cases. In certain areas of southeast and eastern Asia, however, incidence rates are very high, and here there is a strong association with infection with the liver flukes Clonorchis sinensis and Opisthorchis viverrini. The mechanisms of carcinogenesis in O. viverrini infection have been the subject of considerable research; it seems that the presence of parasites induces DNA damage and mutations as a consequence of the formation of carcinogens/free radicals and of cellular proliferation of the intrahepatic bile duct epithelium. Preventive strategies in areas endemic for liver flukes appear straightforward, but breaking the cycle of infection has proved difficult in practice.
胆管癌是一种相对罕见的癌症；在全球范围内，它约占肝癌的15%。在大多数地区，病因相当不明，已确定的危险因素如肝内胆管结石、炎症性肠病和接触钍造影剂仅能解释一小部分病例。然而，在东南亚和东亚的某些地区，发病率非常高，且与中华肝吸虫和麝猫后睾吸虫感染密切相关。麝猫后睾吸虫感染致癌的机制已成为大量研究的主题；似乎寄生虫的存在会因致癌物/自由基的形成以及肝内胆管上皮细胞的增殖而导致DNA损伤和突变。在肝吸虫流行地区的预防策略看似简单，但在实践中证明打破感染循环很困难。
