View
1
Download
0
Category
Preview:
Citation preview
Banchob SripaTropical Disease Research LaboratoryDepartment of PathologyFaculty of Medicine, Khon Kaen University
Geographical Distribution of Liver Cancer and Current Status of Opisthorchis viverrini Infection
in Khon Kaen ProvinceFaculty of Medicine Annual Conference, 17 October 2007
Geographical Distribution of Liver Cancer and Current Status of Opisthorchis viverrini Infection
in Khon Kaen ProvinceFaculty of Medicine Annual Conference, 17 October 2007
Liver Cancer
Hepatocytes (Hepatic cells)Hepatocellular carcinoma
Bile duct epitheliumCholangiocarcinoma
01020304050607080
Thailand, Nort h-East : Khon Kaen
Korea: Busan
The Gambia
Korea: Seoul, Daegu
Japan: Hiroshima, Osaka, Saga Pref ect ures
China: Jiashan, Hong Kong Regions
Mali
Korea: Kangwha Count y
Zimbabwe
Japan: Nagasaki Pref ect ure
Thailand, Nort h: Chiang Mai, Lampang
Viet Nam and Philippines
China: Beijing, Tianjin Regions
Singapore: Chinese, Malays
USA, Calif ornia: Chinese and Koreans
Japan: Miyagi, Yamagat a Pref ect ures
It aly, Out er regions including Parma
Thailand, Cent ral: Bangkok
USA, New Mexico: American Indians
France, Nort hern and Cent ral
Aust ralia, Nort hern Territ ory
It aly, Cent ral excluding Parma
Singapore: Indians
Uganda
Kuwait , Oman, Pakist an
Cent ral Europe, Spain and Port ugal*
Thailand, Sout h: Songkhla
USA: Blacks
Yugoslavia, Vojvodina, Croat ia
Cent ral America*
Russia
France, Sout hern and Islands
USA: Whit es
Canada*
Sout h America*
New Zealand, Aust ralia except NT
Israel*
India*
Nort hern Europe*
Malt a
Alger ia
World Age Standardised Rate (per 100 000 people)
OtherCCAHCC
(WHO, 2002)
Top 10 Diseases with high DALYs in Thailand
Males Females
DALYs DALYs
Rank Disease (X 100,000) % Rank Disease (X 100,000) %
1 HIV/AIDS 9.6 17% 1 HIV/AIDS 3.7 11%
2 Traffic injury 5.1 9% 2 Stroke 2.8 6%
3 Stroke 2.7 5% 3 Diabetes 2.7 6%
4 Liver cancer 2.5 4% 4 Depression 1.5 3%
5 Diabetes 1.7 3% 5 Liver cancer 1.2 3%
6 IHD 1.6 3% 6 Osteoarthritis 1.1 3%
7 COPD (emphysemal)
1.6 3% 7 Traffic injury 1.1 3%
8 Homicide violence 1.6 3% 8 Anemia 1.1 3%
9 Suicides 1.5 3% 9 IHD 1.1 3%
10 Drug dependence 1.4 2% 10 Cataracts 1.0 2%
Weekly Epidemiological Surveillance Report 2004, 35(2): 19-22.
Risk factors of Cholangiocarcinoma : community-based studies
Risk factors n Adjusted odd ratio
OV egg count0 410 1
1-1500 753 1.67 (0.2-16.3)1500-6000 477 3.23 (0.4-29.5)> 6000 167 14.08 (1.67-118.6)
Antibody to OVOD<0.2 180 1OD>0.2 73 27.09 (6.3-116.57)
SexFemale 950 1.0Male 857 3.0 (0.8-11.2)
Age24-34 563 135-49 754 4.57(0.5-38.5)>50 490 9.21 (1.1-74.69)
Praziquantel treatment0 200 11 200 3.4
2-4 200 4.6
(Haswell-Elkins et al, 1994: Chuenroongroj, 2000; Honjo et al., 2005)
Nitric oxide and other oxygen free radicals
MacrophageEosinophilEpithelium NO
Immunosuppression(37 kDa OV antigen)
Inhibit DNA repair(BER-inflammation)8-oxodG (G:C-T:A)
GenotoxicNO & metabolites NDMA adduct
DNA damage amines(8-oxodG)
Inflammation
T cells
IFN, TNFCYP
iNOS nitrotyrosine
Inflammation (H&E)
Cell proliferation (BrdU labeling)
Oxidative DNA damage (8-oxodG)
Apoptosis (TUNEL)
Liver flukeinfection
Epithelial desquamationParasite molecules
Epithelial hyperplasiaGoblet cell metaplasia
Adenomatous hyperplasia
DNAdamage
Genetic alterations
Malignant transformation
Cholangiocarcinoma
Periductal fibrosis
Inflammation(macrophages, mast cells, eosinophils
lymphocytes)
Bile stasisAscendingcholangitis
Exogenous N. (dietary)
Endogenous N.
NO
iNOS
amines
ROI
ImmunopathologyMechanical
50150250350450550650750850950
10501150125013501450
1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
Year
num
ber o
f cas
es
Liver Cervix Lung Blood Breast
Ovary Nasopharynx Lymph Node Thyroid Colon
จํานวนผูปวยใหมในมะเร็ง 10 อันดับแรกในระยะ 10 ป (1997-2006) โ รงพยาบาลศรีนครินทร คณะแพทยศาสตร มหาวทิยาลัยขอนแกน
Tumor Registry, Srimagarind Hospital-KKU (1997-2007)
SUMSUNG
NONG RUA
BAN FANG
KHOK PHO CHAI
MUANG
PHOLNONG SONG HONG
PHRA YUN
BAN HAED
NAM PHONG
WAENG NOI
CHUM PHAE
CHONNABOT
NON SILA
BAN PHAI
SI CHOM PHU
PUAINOI
WAENG YAI
PHU PHAMANPHU WIENG
MANCHAKHIRI
NONG NA KAMUBONRAT
KRANUAN
KHAO SUAN KWANG
0-27.57
27.57-55.14
55.14-82.72
> 82.72
Myanmar
Cambodia
Lao
Gulf ofThailand
And
aman
sea
Bangkok
Songkla
Chiang Mai
CCA incidence = 65.47 (26.46-110.08) per 100,000
OV prevalence = 30%
Malaysia
Incidence of CCA (per 100,000) and prevalence of OV infection in Khon Kaen (1986-2005)
Khon KaenKhon Kaen
ASR (Male) = 96.52ASR (Female) = 38.47
Liver cancer incidence (ASR) (All age group - male)at sub-district level of Khon Kaen Province (1986-2005)
< 40
40-80
80-120
>120
Age distribution of people examined for Opisthorchis viverrini from 5 villagesin Khon Kaen
Overall prevalence 29.8 %(Range 24.5%-51.3%)
4 year-old boy Age groups
Num
ber o
f cas
es
N = 1,276
0
10
20
30
40
50
60
70
80
90
100
0-5y r 5-10y r 10-15y r 15-20y r 20-25y r 25-30y r 30-35y r 35-40y r 40-45y r 45-50y r 50-55y r 55-60y r 60-65y r >65y r
Age
PZQ
trea
tmen
t(s)
No
1
2
3
>3
Frequency of praziquantel treatment in different age-groups in people from 5 villages in Khon Kaen
Recommended