胆管癌是胆道上皮高度侵袭性的癌症。这种癌症在亚洲很常见，并且最近的报告显示在美国的发病率相对较低但在增加。尽管胆管癌的风险因素尚未阐明，但越来越多的文献表明感染食源性寄生虫华支睾吸虫（Clonorchis sinensis）和鳅形吸虫（Opisthorchis viverrini）的易感个体可能在其中起到一定作用。虽然大多数感染者保持无症状，但未经治疗的慢性感染华支睾吸虫和鳅形吸虫可能持续存在于外周肝内胆管近30年。在此期间，寄生虫的摄食活动和分泌物可能损害胆管上皮并促进局部炎症。这些病理过程可能引发上皮剥脱、腺瘤样增生、杯状细胞化生、周管纤维化和肉芽肿形成，有利于在易感人群中引发和推进胆管癌的发生和发展。国际癌症研究机构已确定，慢性感染华支睾吸虫和鳅形吸虫在人类中具有致癌性的充分证据。及时的华支睾吸虫和鳅形吸虫感染的血清诊断对于越南战争退伍军人可能是一个重要的风险因素，因为这些寄生虫可能导致胆管癌。大约有774,000名在越南服役的美国人现在还活着，迫切需要开发敏感且特异的血清学检测方法来检测急性和慢性感染。我们认为对高风险人群进行测试和治疗可能会使胆管癌的早期发现和治疗更加容易，从而提高总体生存率。版权所有©2023年 Frontline Medical Communications Inc., Parsippany, NJ, USA.

Cholangiocarcinoma is a highly aggressive cancer of the biliary tract epithelium. This form of cancer is prevalent in Asia, and recent reports show that its incidence is relatively rare but increasing in the United States. Although risk factors for cholangiocarcinoma have yet to be elucidated, a growing body of literature suggests chronic infection of genetically susceptible individuals with the food-borne zoonotic trematodes Clonorchis sinensis (C sinensis) and Opisthorchis viverrini (O viverrini) may play a role.Although most infected people remain asymptomatic, untreated indolent infections with C sinensis and O viverrini may persist in peripheral intrahepatic bile ducts for almost 30 years. During this period, the trematodes' feeding activities and their excretory-secretory products may damage the bile duct epithelium and promote local inflammation. These pathological processes could then provoke epithelial desquamation, adenomatous hyperplasia, goblet cell metaplasia, periductal fibrosis, and granuloma formation that are conducive to the initiation and progression of cholangiocarcinoma in genetically susceptible people. The International Agency for Research on Cancer has determined that there is sufficient evidence in humans for the carcinogenicity of chronic infections with C sinensis and O viverrini.Timely serodiagnosis of indolent C sinensis and O viverrini infections is important as these parasites may be a risk factor for cholangiocarcinoma in veterans who served in Vietnam. About 774,000 living Americans served in Vietnam and there is an urgent need to develop sensitive and specific serologic assays to detect both acute and indolent infections. We posit that testing and treatment of high-risk populations could lead to earlier detection and treatment of cholangiocarcinoma, leading to improved overall survival.Copyright © 2023 Frontline Medical Communications Inc., Parsippany, NJ, USA.