Opisthorchiasis and cholangiocarcinoma in South East Asia: an unresolved problem
Author(s)
Type
Journal Article
Abstract
The prevalence of cholangiocarcinoma (CCA) in Southeast Asia is much higher than other areas of the world. Eating raw, fermented or undercooked cyprinid fish, infected with the liver fluke, Opisthorchis viverrini sensu lato, results in chronic biliary inflammation, periductal fibrosis, and increased cancer risk. There may be associated glomerulonephritis. The process of infection is difficult to disrupt because eating practices have proven extremely difficult to change, and the life cycle of the fluke cannot be broken due to high prevalence in canine and feline reservoir hosts. Fecal analysis and ELISA tests can be used to diagnose opisthorchiasis. Diagnosis of CCA is complex, partly due to the lack of definitive imaging characteristics and also due to the difficulty of obtaining samples for cytology or histology. This cancer has proven to be resistant to common chemotherapy treatments and so the two avenues of treatment available are surgical resection and liver transplantation, both requiring early detection of the tumor for the best chances of success. Late presentation of symptoms reduces the chances of successful surgical intervention. While liver fluke infections can be treated with praziquantel, individuals will often become re-infected, and multiple reinfections can be more harmful than a singular, long term infection. A key research need is for the detection and characterization of novel biomarkers in all parts of the carcinogenic pathway for early diagnosis.
Date Issued
2017-08-10
Date Acceptance
2017-03-22
Citation
International Journal of General Medicine, 2017, 2017 (10), pp.227-237
ISSN
1178-7074
Publisher
Dove Medical Press
Start Page
227
End Page
237
Journal / Book Title
International Journal of General Medicine
Volume
2017
Issue
10
Copyright Statement
This work is published by Dove Medical Press Limited, and licensed under a Creative Commons Attribution License. The full terms of the License are available at http://creativecommons.org/licenses/by/4.0/. The license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
License URL
Sponsor
Wellcome Trust
Wellcome Trust
Wellcome Trust
Wellcome Trust
Grant Number
097816/Z/11/ZR
097816/Z/11/A
097816/Z/11/B
105603/Z/14/Z
Subjects
CCA
Laos
Opisthorchis viverrini
Thailand
carcinogen
helminth
parasite
public health
treatment
1103 Clinical Sciences
Publication Status
Published