Cholangiocarcinoma risk factors
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Suveenkrishna Pothuru, M.B,B.S. [2]
Overview
Common risk factors in the development of cholangiocarcinoma are chronic inflammatory conditions of bile duct, liver fluke infections, choledochal cysts, toxins, and viral infections.
Risk Factors
A number of risk factors for the development of cholangiocarcinoma have been described; in the Western world, the most common of these is primary sclerosing cholangitis (PSC), an inflammatory disease of the bile ducts which is in turn closely associated with ulcerative colitis (UC). Epidemiologic studies have suggested that the lifetime risk of developing cholangiocarcinoma for a person with PSC is 10%–15%,[1] although autopsy series have found rates as high as 30% in this population. The mechanism by which PSC increases the risk of cholangiocarcinoma is not well-understood. Clinical data has suggested that the development of cholangiocarcinoma is related to several factors.[2]
Chronic inflammation of the bile duct:[3]
- Primary sclerosing cholangitis (major risk factor in western countries)
- Recurrent pyogenic cholangitis (major risk factor in endemic areas)
- Ulcerative colitis
- Cholelithiasis
- Cirrhosis
Liver fluke infections: Liver fluke infection is a major cause of cholangiocarcinoma in some Asian countries.[4][5][6]
- Opisthorchis viverrini (found in Thailand, Laos, and Malaysia)
- Clonorchis sinensis (found in Japan, Korea, and Vietnam)
Choledochal cysts:
- Caroli's disease
- Thorotrast(widely used as a contrast agent for x-rays until 1950s)
- Dioxin
- Polyvinyl chloride
- Heavy alcoholism
- HIV
- Hepatitis B
- Hepatitis C
- EBV
- Lynch syndrome II
- Biliary papillomatosis
Obesity
References
- ↑ Epidemiologic studies which have addressed the incidence of cholangiocarcinoma in people with primary sclerosing cholangitis include the following:
- Bergquist A, Ekbom A, Olsson R, Kornfeldt D, Lööf L, Danielsson A, Hultcrantz R, Lindgren S, Prytz H, Sandberg-Gertzén H, Almer S, Granath F, Broomé U (2002). "Hepatic and extrahepatic malignancies in primary sclerosing cholangitis". J Hepatol. 36 (3): 321–7. PMID 11867174.
- Bergquist A, Glaumann H, Persson B, Broomé U (1998). "Risk factors and clinical presentation of hepatobiliary carcinoma in patients with primary sclerosing cholangitis: a case-control study". Hepatology. 27 (2): 311–6. PMID 9462625.
- Burak K, Angulo P, Pasha T, Egan K, Petz J, Lindor K (2004). "Incidence and risk factors for cholangiocarcinoma in primary sclerosing cholangitis". Am J Gastroenterol. 99 (3): 523–6. PMID 15056096.
- ↑ Cholangiocarcinoma. Radiopaedia. http://radiopaedia.org/articles/cholangiocarcinoma
- ↑ Chapman R. "Risk factors for biliary tract carcinogenesis". Ann Oncol. 10 Suppl 4: 308–11. PMID 10436847.
- ↑ Watanapa P (1996). "Cholangiocarcinoma in patients with opisthorchiasis". Br J Surg. 83 (8): 1062–64. PMID 8869303.
- ↑ Watanapa P, Watanapa W (2002). "Liver fluke-associated cholangiocarcinoma". Br J Surg. 89 (8): 962–70. PMID 12153620.
- ↑ Shin H, Lee C, Park H, Seol S, Chung J, Choi H, Ahn Y, Shigemastu T (1996). "Hepatitis B and C virus, Clonorchis sinensis for the risk of liver cancer: a case-control study in Pusan, Korea". Int J Epidemiol. 25 (5): 933–40. PMID 8921477.
- ↑ Sahani D, Prasad S, Tannabe K, Hahn P, Mueller P, Saini S. "Thorotrast-induced cholangiocarcinoma: case report". Abdom Imaging. 28 (1): 72–4. PMID 12483389.
- ↑ Zhu A, Lauwers G, Tanabe K (2004). "Cholangiocarcinoma in association with Thorotrast exposure". J Hepatobiliary Pancreat Surg. 11 (6): 430–3. PMID 15619021.
- ↑ Kobayashi M, Ikeda K, Saitoh S, Suzuki F, Tsubota A, Suzuki Y, Arase Y, Murashima N, Chayama K, Kumada H (2000). "Incidence of primary cholangiocellular carcinoma of the liver in Japanese patients with hepatitis C virus-related cirrhosis". Cancer. 88 (11): 2471–7. PMID 10861422.
- ↑ Yamamoto S, Kubo S, Hai S, Uenishi T, Yamamoto T, Shuto T, Takemura S, Tanaka H, Yamazaki O, Hirohashi K, Tanaka T (2004). "Hepatitis C virus infection as a likely etiology of intrahepatic cholangiocarcinoma". Cancer Sci. 95 (7): 592–5. PMID 15245596.
- ↑ Lu H, Ye M, Thung S, Dash S, Gerber M (2000). "Detection of hepatitis C virus RNA sequences in cholangiocarcinomas in Chinese and American patients". Chin Med J (Engl). 113 (12): 1138–41. PMID 11776153.
- ↑ Mecklin J, Järvinen H, Virolainen M (1992). "The association between cholangiocarcinoma and hereditary nonpolyposis colorectal carcinoma". Cancer. 69 (5): 1112–4. PMID 1310886.
- ↑ Lee S, Kim M, Lee S, Jang S, Song M, Kim K, Kim H, Seo D, Song D, Yu E, Lee S, Min Y (2004). "Clinicopathologic review of 58 patients with biliary papillomatosis". Cancer. 100 (4): 783–93. PMID 14770435.