Hepatitis B virus infection increases the risk of cholangiocarcinoma: A meta‐analysis and systematic review

Abstract

Background and Aim: A number of studies have shown that hepatitis virus infections may be associated with cholangiocarcinoma (CC). However, the relationship between hepatitis B virus (HBV) infection and CC, especially intrahepatic cholangiocarcinoma (ICC), is still controversial. Methods: Relevant studies were identified by searching PUBMED, EMBASE and Web of Science Datebases up to September 2011. Pooled risk estimates were calculated using a random‐effects model. Potential sources of heterogeneity were performed by subgroup analyses. A total of 18 papers were included in this meta‐analysis. Results: The pooled risk estimate of all studies showed a statistically significant increased risk of CC among individuals with HBV infection (rate ratio [RR]: 2.66; 95% confidence interval [CI]: 1.97, 3.60). Compared with those without HBV infection, persons with HBV infection had an increased risk of intra‐CC (ICC) (RR: 3.42; 95% CI: 2.46, 43.74), extrahepatic CC (OR: 1.46; 95% CI: 0.98, 2.17), and CC (OR: 2.03; 95% CI: 1.15, 3.56). In a subgroup analysis of HBV infection and risk of ICC, the pooled risk estimate of studies in Asians (RR: 3.63; 95% CI: 2.56, 5.13) was higher than that in non‐Asians (RR: 1.93; 95% CI: 0.78, 4.76). A Begg funnel plot and Egger test revealed no evidence for publication bias. Conclusions: This meta‐analysis shows that HBV is associated with increased risk of CC, especially for ICC. Further investigation is needed to focus on the mechanism by which HBV may be involved in the pathogenesis of CC.

Clinical Significances of Preoperative Classification of Intrahepatic Cholangiocarcinoma: Different Characteristics of Perihilar vs. Peripheral ICC

“…Therefore, peripheral ICC may develop from small bile ducts or hepatocytes. The relationship between HBV infection (odds ratio, OR; 2.66), cirrhosis (OR; 22.9) and ICC carcinogenesis were supported by two meta-analyses (18,19). In addition, some studies have reported conflicting findings as to whether HBV, HCV or both were associated with ICC (18,20).…”

Epidemiology and Risk Factors of Cholangiocarcinoma

“…The risk estimates for IH-CCA were increased for both HBV and HCV, whereas the association of HBV and IH-CCA was greater in Asian patients but lower for HCV and CCA as compared to Western patients [56,57]. For HBV infection alone, the risk of CCA was confirmed to be greater in Asia than in the West [58]. …”

Metformin Exerts Antiproliferative and Anti-metastatic Effects Against Cholangiocarcinoma Cells by Targeting STAT3 and NF-ĸB

“…A high incidence of CCA has been noted in the Northeast of Thailand and infection with the liver fluke, Opisthorchis viverrini has been shown to be a strong risk factor for CCA in this region (1). Primary sclerosing cholangitis, hepatolithiasis, and hepatitis B virus infection, however, are the documented risk factors for CCA in Western countries (2,3). CCA is a lethal type of cancer since early diagnosis is rarely possible.…”