Risk factors for cholangiocarcinoma

Abstract

Cholangiocarcinoma is the second most common primary hepatic malignancy after hepatocellular cancer. It accounts for approximately 10–25% of all hepatobiliary malignancies. There are considerable geographic and demographic variations in the incidence of cholangiocarcinoma. There are several established risk factors for CC including parasitic infections, primary sclerosing cholangitis, biliary-duct cysts, hepatolithiasis, and toxins. Other less-established, potential risk factors include inflammatory bowel disease, hepatitis C virus, hepatitis B virus, cirrhosis, diabetes, obesity, alcohol drinking, tobacco smoking, and host genetic polymorphisms. In studies where the distinction between ICC and ECC was used, some potential risk factors seem to have differential effect on CC depending on site. Therefore, the consistent use of more refined classification would allow better understanding of risk factors for cholangiocarcinoma.

Inflammatory Bowel Disease and Risk of Cholangiocarcinoma: Evidence from a Meta-analysis of Population-based Studies

“…However, our data suggest that IBD patients have lower risk of ECC than that of ICC, but the estimates were imprecise (RR: 2.61 versus 1.47 for ICC versus ECC). The differential effect on ICC and ECC implies different pathogenesis involved due to differing clinical presentation and natural history (Tyson et al, 2011;Palmer et al, 2012). Moreover, results of subgroup analyses raise the possibility of geographic variations in the risk of CC in IBD patients but are limited by the small number of studies and participants, thus additional studies from regions in Asia are warranted.…”

“…Anatomically, CC can be categorized as intrahepatic CC (ICC) and extrahepatic CC (ECC) on the basis of its location (Patel., 2011). Klatskin tumor, i.e Hilar CC, is typically classified as extrahepatic (Tyson et al, 2011). The clinical distinction between ICC and ECC has become significantly crucial due to their possibly different epidemiological characteristics (Patel., 2006;Gatto et al, 2010).…”

“…Epidemiological studies have found that primary sclerosing cholangitis (PSC), liver flukes infestation and cholecystitis are well-established (Tyson et al, 2011;Songserm et al, 2012;Hussain et al, 2013;Manwong et al, 2013). Also, hepatitis virus infection may also play a role in the development of CC (Srivatanakul et al, 2010).…”

Over 6-year survival in locally advanced cholangiocarcinoma – a case report

“…The carcinoembrionar CA19-9 tumor marker is two-folds increased -73.9 U/ml. The blood tests also revealed thrombocytopenia (142,000/mm 3 ), anemia (Hb=9.7 g/dl), erythropenia (3.25 million), and increased levels of glycolytic hemoglobin (13.3%). The urinary sediment showed pyuria (52 WBC/mm 3 ) and a large amount of bacterial flora (19259.4 CFU/mL).…”

“…Throughout the last decades, the incidence of CCAs had notably increased probably due to the high occurrence of some risk factors [2]. Tyson et al established some risk factors for CCAs including parasitic infections, primary sclerosing cholangitis, hepatolithiasis, biliary-duct cysts and toxins [3]. Other less-proven, possible risk factors include inflammatory bowel disease (IBD), hepatitis C virus infection, hepatitis B virus infection, liver cirrhosis, mellitus diabetes, obesity, alcohol abuse, smoking, and host genetic polymorphisms [3].…”