Opisthorchiasis, hypercholesterolemia, and cholangiocarcinoma: A reappraisal.

Dear Editor

Opisthorchiasis is a common fluke infestation that can be seen in many countries around the world. The chronic opisthrochiasis is proved for its relationship with cholangiocarcinogenesis.[1] A recent report showed that the important biochemical metabolite of parasite relating to carcinogenesis is sterol.[2] In fact, the disturbance of gall bladder in chronic opisthrochiasis is observed and this can result in abnormal serum biochemical parameters, especially for lipid profile.[3] In addition, the abnormal gall bladder physiology can further result in carcinogenesis.[3] Of interest, the abnormality persist despite successful antihelminthic therapy.[4] However, it has never been systematically studied on the incidence of hypercholesterolemia among the cases with cholangiocarcinoma. The authors performed a re-assessment of the data on our patients in a previous report.[5] Of 62 cases, it can be seen that 50 cases (80.6%) had concurrent hypercholesterolemia. The very high incidence can be observed. The authors proposed that hypercholesterolemia might be included as an important clinical character of chronic opisthorchiasis. In endemic area, the stool examination for screening for Opisthorchis spp. is suggested for all patients with hypercholesterolemia. In addition, since abnormal sterol metabolite plays very important role in carcinogenesis, anyone with identified Opisthorchis spp. in stool should be strictly controlled for fat dietary.

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