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Primary liver cancer coincident with schistosomiasis japonica. A study of 24 necropsies
Author(s) -
Nakashima Toshiro,
Okuda Kunio,
Kojiro Masamichi,
Sakamoto Kazuyoshi,
Kubo Yasuhiko,
Shimokawa Yutaka
Publication year - 1975
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(197510)36:4<1483::aid-cncr2820360441>3.0.co;2-9
Subject(s) - schistosomiasis , medicine , hepatocellular carcinoma , cirrhosis , schistosomiasis japonica , cancer , pathology , carcinoma , hepatitis , schistosoma japonicum , viral hepatitis , gastroenterology , immunology , helminths
The etiologic relationship of parasitic liver disease to primary liver cancer has long been debated. For this reason, a review of 4611 necropsies was carried out to determine the frequency with which hepatocellular carcinoma occurred in association with schistosomiasis. Of 227 cases of hepatocellular carcinoma, 24 (10.6%) were associated with schistosomiasis japonica. This was significantly higher than the incidence of this carcinoma without schistosomiasis (2.78%). The majority of the 24 cases exhibited the features of a mixed macronodular and micronodular cirrhosis (Gall's posthepatitic cirrhosis); this was superimposed upon and caused a masking of schistosomiasis fibrosis. By radioimmunoassay hepatitis B antigen was positive in 27% of these cases. A review of the literature indicated that chronic schistosomiasis, on its own, is unlikely to be the cause of primary liver cell carcinoma. Histologic features resembling posthepatitic cirrhosis combined with a high frequency of hepatitis B antigen suggest that viral hepatitis rather than S. japonicum is the more likely etiologic factor involved, or has a synergistic effect on carcinogenesis.