Cholangiocarcinoma: lessons from Thailand.
Banchob Sripa1, Chawalit Pairojkul
1Department of Pathology, Faculty of Medicine, Thailand.
Current Opinion in Gastroenterology
|April 15, 2008
Summary
Cholangiocarcinoma (bile duct cancer) is most common in Thailand, linked to the liver fluke Opisthorchis viverrini. New data reveals high-incidence areas beyond the northeast, underscoring the urgent need for fluke eradication.
Area of Science:
- Hepatobiliary Medicine
- Cancer Epidemiology
- Parasitology
Background:
- Cholangiocarcinoma (bile duct cancer) is a significant health concern in Thailand.
- The liver fluke, Opisthorchis viverrini, is a known risk factor for this cancer.
- Understanding the epidemiology and pathogenesis is crucial for control.
Purpose of the Study:
- To review recent epidemiological data on liver fluke-associated cholangiocarcinoma in Thailand.
- To elucidate the cellular and molecular pathogenesis of bile duct cancer linked to Opisthorchis viverrini.
- To highlight the current burden and geographical distribution of this malignancy.
Main Methods:
- Analysis of recent tumor registration data in Thailand.
- Review of scientific literature on the epidemiological and etiological aspects of cholangiocarcinoma.
- Examination of cellular and molecular mechanisms linking liver fluke infection to cancer development.
Main Results:
- New high-incidence areas for cholangiocarcinoma identified in northern Thailand, expanding beyond the northeast.
- The association between Opisthorchis viverrini infection and cholangiocarcinoma pathogenesis is further clarified.
- Thailand continues to report the highest global incidence of cholangiocarcinoma.
Conclusions:
- Liver fluke infection initiates chronic inflammation, causing oxidative DNA damage in biliary epithelium.
- This damage leads to malignant transformation and the development of bile duct cancer.
- Urgent strategies for fluke eradication and identification of high-risk populations are necessary to reduce cancer incidence.
