- Volume 14 Issue 11
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Association between Praziquantel and Cholangiocarcinoma in Patients Infected with Opisthorchis viverrini: A Systematic Review and Meta-Analysis
- Kamsa-Ard, Supot (Cancer Unit, Srinagarind Hospital, Khon Kaen University) ;
- Laopaiboon, Malinee (Department of Biostatistics and Demography, Faculty of Public Health, Khon Kaen University) ;
- Luvira, Vor (Department of Surgery, Faculty of Medicine, Khon Kaen University) ;
- Bhudhisawasdi, Vajarabhongsa (Department of Surgery, Faculty of Medicine, Khon Kaen University)
- Published : 2013.11.30
Background: The liver fluke, Opisthorchis viverrini, and the associated incidence of subsequent cholangiocarcinoma (CCA) are still a public health problem in Thailand, and praziquantel (PZQ) remains the antihelminthic drug of choice for treatment. Evidence in hamsters shows that repeated infection and PZQ treatments could increase the risk of CCA. However, the existing evidence in humans is inconclusive regarding increased risk of CCA with frequency of PZQ intake. Objectives: To investigate the relationship between number of repeated PZQ treatments and CCA in patients with O viverrini infection. Materials and Methods: The reviewed studies were searched in EMBASE, MEDLINE, ProQuest, PubMed and SCOPUS from inception to October, 2012 using prespecified keywords. The risk of bias (ROB) of included studies was independently assessed by two reviewers using a quality scale from the Newcastle-Ottawa Scale (NOS). Risk effect of PZQ was estimated as a pooled odds ratio (OR) with its 95% confidence interval (95%CI) in the random-effects model using DerSimonian and Laird's estimator. Results: Three studies involving 637 patients were included. Based on the random effects model performed in two included studies of 237 patients, the association between PZQ treatments and CCA was not statistical significant with a pooled OR of 1.8 (95%CI; 0.81 to 4.16). Conclusions: The present systematic review and meta-analysis provides inconclusive evidence of risk effect of PZQ on increasing the risk of CCA and significant methodological limitations. Further research is urgently needed to address the shortcomings found in this review, especially the requirement for histological confirmation.
Cholangiocarcinoma;Opisthorchis viverrini;repeated praziquantel;treatments;systematic review
- Bhamarapravati N, Virranuvatti V (1966). Liver diseases in Thailand An analysis of liver biopsies. Am J Gastroenterol, 45, 267-75.
- Bhudhisawasdi V, Khuntikeo N, Chur-in S, et al (2012). Cholangiocarcinoma: Experience of Srinagarind Hospital. Srinagarind Med J, 27, 331-9.
- Charoensuk L, Pinlaor P, Prakobwong S, et al (2011). Curcumin induces a nuclear factor-erythroid 2- related factor 2-driven response against oxidative and nitrative stress after praziquantel treatment in liver fluke-infected hamsters. Int J Parasitol, 41, 615-26. https://doi.org/10.1016/j.ijpara.2010.12.011
- Chemrungroj G (2000). Risk factor for cholangiocarcinoma: a case control study: Doctoral Dissertation to the Faculty of the Graduate School, Yale University.
- Chai JY, Hongvanthong B (1998). A small-scale survey of intestinal helminthic infections among the residents near Pakse, Laos. Korean J Parasitol, 36, 55-8. https://doi.org/10.3347/kjp.1918.104.22.168
- De NV, Murrell KD, Cong LD, et al (2003): The food-borne trematode zoonoses of Vietnam Southeast Asian J Trap Med Public Health, 34,12-34.
- Deerasamee S, Martin N, Sontilxmg S, et al (1999). Cancer in Thailand Vol. 11, 1992-1994. IARC Technical Report No. 34, Lyon: lARC
- dos Santos Silva I (1999). Cancer epidemiology: Principles and methods IARC (International Agency for Research on Cancer), Lyon, Intemational Agency for Research on Cancer.
- Grundy-Warr C, Andrews RH, Sithithawom P, et al (2012). Raw attitudes, wetland cultures, life-cycles: socio-cultural dynamics relating to Opisthorchis viverrini in the Mekong Basin. ParasitolInt, 61, 65-70.
- Haswell-Elkins MR, Mairiang E, Mairiang P, et al, (1994). Cross-sectional study of Opisthorchis viverrini infection and cholangiocarcinoma in communities within a high-risk area in northeast Thailand. Int J Cancer, 59, 505-9. https://doi.org/10.1002/ijc.2910590412
- Higgins JPT, Thompson SG, Deeks JJ, et al. (2003) Measuring inconsistency in meta-analyses. BMJ, 327, 557-60. https://doi.org/10.1136/bmj.327.7414.557
- Honjo S, Srivatanakul P, Sriplung H, et al (2005). Genetic and environmental determinants of risk for cholangiocarcinoma via Opisthorchis viverrini in a densely infested area in Nakhon Phanom, northeast Thailand. Int J Cancer, 117, 854-60. https://doi.org/10.1002/ijc.21146
- Jongsuksuntigul P (2002). Seminar in Parasitic Diseases in northeast Thailand. Klungnana Vitaya, Khon Kaen; Thailand: 2002. Parasitic disease in Northeast Thailand.
- Kaewpitoon N, Kaewpitoon S-J, Pengsaa P (2008). Opisthorchiasis in Thailand: review and current status. World J. Gastraenteral, 14, 2297-302.
- Khuhaprema T, Attasara P, Sriplung H, et al (2012). Liver and Bile duct. Cancer in Thailand, 6, 29-31.
- Khuhaprema T, Srivatanakul P, Attasara P, et al (2010). Liver and Bile duct. Cancer in Thailand, 5, 31-33.
- Khuhaprema T, Srivatanakul P, Sriplung H, et al (2007). Liver and Bile duct. Cancer in Thailand, 4, 36-38.
- Lee K-J, Bae Y-T, Kim D-H, et al (2002): Status of intestinal parasites infection among primary school children in Kampongcham, Cambodia. Korean J Parasitol, 40, 153-5. https://doi.org/10.3347/kjp.2002.40.3.153
- Non-Randomized Studies Methods Group (NRSMG) (2013). The Cochrane Collaboration.
- Parkin DM, Srivatanakul P, Khlat M, et al (1991). Liver cancer in Thailand. I. A case-control study of cholangiocarcinoma. Int J Cancer, 48, 323-8. https://doi.org/10.1002/ijc.2910480302
- Pinlaor S, Ma N, Hiraku Y, et al (2004). Repeated infection with Opisthorchis viverrini induces accumulation of 8-nitroguanine and 8-oxo-7,8-dihydro-2' -deoxyguanine in the bile duct of hamsters via inducible nitric oxide synthase. Carcinogenesis, 25, 1535-42. https://doi.org/10.1093/carcin/bgh157
- Pinlaor S, Prakobwong S, Boonmars T, et al (2009). Effect of praziquantel treatment on the expression of matrix Metalloproteinases in relation to tissue resorption during fibrosis in hamsters with acute and chronic Opisthorchis viverrini infection. Acta Tropica, 111, 181-91. https://doi.org/10.1016/j.actatropica.2009.04.011
- Poomphakwaen K, Promthet S, Kamsa-ard S, et al (2009). Risk Factors for Cholangiocarcinoma in Khon Khaen, Thailand: A Nested Case-Control Study. Asian Pac J Cancer Prev, 10, 251-7.
- RevMan (2008). The Cochrane Collaboration Review Manager (RevMan) 5.0. Copenhagen, The Nordic Cochrane Centre: The Cochrane Collaooration
- Sithithaworn P (2005). Current Roles of Liver Fluke on Occurrence of Cholangiocarcinoma. Srinagarind Med J, 20, 135-42.
- Sithithaworn P, Haswell-Elkins M (2003). Epidemiology of Opisthorchis viverrini. Acta Trap, 88, 187-94. https://doi.org/10.1016/j.actatropica.2003.02.001
- Sripa B, Bethony JM, Sithithaworn P, et al (2011). Opisthorchiasis and Opisthorchis-associated cholangiocarcinoma in Thailand and Laos. Acta Trop, 120, 158-68. https://doi.org/10.1016/j.actatropica.2010.07.006
- Sripa B, Kaewkes S, Sithithaworn P, et al (2007). Liver fluke induces cholangiocarcinoma. PLoS Med, 4, 201. https://doi.org/10.1371/journal.pmed.0040201
- Sripa B, Yongvanit P, Pairojkul C (2005). Etiology and pathogenesis of cholangiocarcinoma: introduction to the association with liver fluke infection. Srinagarind Med J, 20, 122-34.
- Sriplung H, Sontipong S, Martin N, et al (2003) .Cancer in Thailand Vol.lll, 1995-1997. Bangkok: Bangkok Medical Publisher.
- Thamavit W, Bhamarapravati N, Sahaphong S, et al (1978). Effects of dimethylnitrosamine on induction of cholangiocarcinoma in Opisthorchis viverrini-infected Syrian golden hamsters. Cancer Res, 38, 4634-9.
- Upatham ES, Viyanant V, Brockelman WY, et al (1988). Rate of re-infection by Opisthorchis viverrini in an endemic northeast Thai community after chemotherapy. Int J Parasitol, 18, 643-9. https://doi.org/10.1016/0020-7519(88)90099-9
- Vatanasapt V, Martin N, Sriplung H, et al (1993). Cancer in Thailand 1988-1991. (lARC Technical Report No. 16), Lyon, IARC
- Wells GA, Shea B, O'Connell D, et al (2012). The Newcastle-Ottawa Scale (NOS) for assessing the quality of nomandomised studies in meta-analyses.
- WHO (1995). Control of foodborne trematode infections. Report of a WHO Study Group. World Health Organ Tech Rep Ser, 849, 1-157.
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- Prevalence and Risk Factors for Opisthorchis viverrini Infections in Upper Northeast Thailand vol.15, pp.16, 2014, https://doi.org/10.7314/APJCP.2014.15.16.6609
- Untangling the Complexity of Liver Fluke Infection and Cholangiocarcinoma in NE Thailand Through Transdisciplinary Learning vol.13, pp.2, 2016, https://doi.org/10.1007/s10393-015-1087-3
- Reinfection by Opisthorchis Viverrini after Treatment with Praziquantel vol.17, pp.2, 2016, https://doi.org/10.7314/APJCP.2016.17.2.857
- Evaluation of Cholangiocarcinoma Risk and its Related Factors In Wetland Geographical Communities of Ubon Ratchathani, Thailand vol.17, pp.4, 2016, https://doi.org/10.7314/APJCP.2016.17.4.1811
- Life by the river: neglected worm infection in Western Siberia and pitfalls of a one-size-fits-all control approach pp.1469-3682, 2017, https://doi.org/10.1080/09581596.2017.1378425
- Thinking beyond Opisthorchis viverrini for risk of cholangiocarcinoma in the lower Mekong region: a systematic review and meta-analysis vol.7, pp.1, 2018, https://doi.org/10.1186/s40249-018-0434-3