Risk factors of cholangiocarcinogenesis in parasitization of a natural focal ecopathogen helminth Opisthorchis felineus

Epidemiological researches, carried out by professor A.A. Shain in Ob-Irtysh basin of Tyumen region, have allowed to consider chronic opisthorchiasis as facultative liver precancer and develop the original concept of cholangiocarcinogenesis on the background of long-term invasion by trematode Opisthorchis felineus of hepatobiliary system of the body. According to this concept, the initiating role in cholangiocyte transformation belongs to endogenous factors - secondary bile acids, having mutagenic/carcinogenic properties, which formation is mediated by helminthosis-related exogenous intestinal microflora in intrahepatic bile ducts. Obtained data confirmed content of endogenous carcinogenic factors - secondary bile acids in duct bile of chronic opistorchosis patients. Cholestasis, caused by long-term parasitization of helminth Opisthorchis felineus in hepatobiliary system of the body, mediates formation of the host promoter factors, contributing to cholangiocarcinoma progression. These include: high concentration in duct bile of bile acids, products of helminths activity and lipid peroxidation of somatic cell membranes. Promoter factors of cholangiocanerogenesis are also - disorders of cholangiocyte membranes structure, tissue regulation of their regeneration, DNA repair and anti-tumorigenic protection of the body. The results of the study confirm the concept of occurrence and development of the process of cholangiocarcinogenesis in chronic opistorchosis infestation, proposed by Professor A.A. Shain and allow to reasonably develop approaches to the correction of homeostasis regulation systems of the organism in the specified helminthiasis. Which also determines the secondary prevention of malignant process in ductal epithelium of hepatobiliary system in posthelminthic period.