Liver Fluke-Associated Biliary Tract Cancer
Open accessAbstract
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.
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Major risk factors for cholangiocarcinoma vary by region and include liver flukes (e.g., in the northeast region of Thailand, where Opisthorchis viverrini is endemic) and metabolic conditions (including obesity, diabetes, and nonalcoholic fatty liver disease), alongside heavy alcohol consumption and HBV and HCV infections.
“Major risk factors for cholangiocarcinoma also vary by region and include liver flukes (e.g., in the northeast region of Thailand, where Opisthorchis viverrini, is endemic) 121 and metabolic conditions (including obesity, diabetes, and nonalcoholic fatty liver disease), alongside heavy alcohol consumption and HBV and HCV infections.122-124”
From Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. (2024) · cites this paper as [121]
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References 97 · Cited by 118
- Authors
- Prueksapanich, P., Piyachaturawat, P., Aumpansub, P., Ridtitid, W., Chaiteerakij, R., & Rerknimitr, R.
- Affiliations
- Chulalongkorn University (TH)
- Corresponding author
- Rerknimitr, Rungsun
- ORCID
- Venue
- Gut and Liver
- Published
- 2018-05-15
- Volume
- 12
- Issue
- 3
- Pages
- 236-245
- ISSN
- 1976-2283 (ISSN-L)
- 2005-1212
- PMC
- PMC5945254
- OpenAlex
- W2743598935
- Cited by
- 118
- References
- 97
- Citations by year
- 2026: 15 · 2025: 11 · 2024: 19 · 2023: 20 · 2022: 20 · 2021: 13 · 2020: 11 · 2019: 5 · 2018: 4
- FWCI
- 1.16
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- Locations
- Gut and Liver (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Cholangiocarcinoma and Gallbladder Cancer Studies
- Life Sciences › Immunology and Microbiology › Parasitology › Parasites and Host Interactions
- Health Sciences › Medicine › Hepatology › Liver Diseases and Immunity
- Keywords
- cholangiocarcinoma, liver fluke, Clonorchis sinensis, primary sclerosing cholangitis, carcinogenesis, excretory-secretory antigens, biomarkers, cancer prevention, vaccines, climate change, vector-borne parasitic disease
- MeSH terms
- Animals, Anthelmintics, Bile Duct Neoplasms, Clonorchiasis, Fasciola hepatica, Fascioliasis, Feces, Host-Parasite Interactions, Humans, Immunity, Cellular, Life Cycle Stages, Parasitology, Risk Factors, Saliva, Urine, Vaccines, Global Health, Biomarkers, Helminth Proteins, Cholangiocarcinoma, Cell Proliferation, Climate Change, Microbiota
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