Tao Lian-yuan, He Xiao-dong, Cai Lei, Liu Wei, Ji Wen-juan, Zhao Lei, Zhang Shuang-min
Department of Liver Surgery, Peking Union Medical College Hospital (PUMCH), Beijing 100730, China.
Zhonghua Zhong Liu Za Zhi. 2009 Oct;31(10):759-63.
To investigate the risk factors of intrahepatic cholangiocarcinoma (ICC) and extrahepatic cholangiocarcinoma (ECC).
The clinicopathological data of 190 patients with cholangiocarcinomas (61 ICC and 129 ECC) diagnosed and treated in the Peking Union Medical College Hospital between 1998 and 2008 were collected. The clinicopathological data of 380 matched healthy controls were also collected. The information about liver diseases, family history, diabetes, smoking and drinking were recorded and analyzed.
The positive rate of HBsAg(+) and anti-HBc(+), HBsAg(-) and anti-HBc(+) and the incidence of choledocholithiasis or hepatolithiasis in ICC patients were 27.9%, 50.8% and 14.8%, respectively. The incidence of diabetes mellitus, cholecystolithiasis, choledocholithiasis or hepatolithiasis and previous cholecystectomy in ECC patients were 18.6%, 15.5%, 18.6% and 13.2%, respectively. The incidences of all above mentioned factors in the ICC or ECC patients were significantly higher than that in the controls (P < 0.05). Compared with the patients with ECC, the ICC patients had a significantly higher cirrhosis rate (P < 0.05).
Our study results show that choledocholithiasis or hepatolithiasis, liver cirrhosis and chronic HBV infection are possible risk factors for intrahepatic cholangiocarcinoma, while choledocholithiasis or hepatolithiasis, diabetes mellitus, cholecystolithiasis, history of cholecystectomy are risk factors for extrahepatic cholangiocarcinoma.
探讨肝内胆管癌（ICC）和肝外胆管癌（ECC）的危险因素。
收集1998年至2008年在北京协和医院诊断和治疗的190例胆管癌患者（61例ICC和129例ECC）的临床病理资料。同时收集380例匹配的健康对照者的临床病理资料。记录并分析有关肝脏疾病、家族史、糖尿病、吸烟和饮酒的信息。
ICC患者中HBsAg(+)和抗-HBc(+)、HBsAg(-)和抗-HBc(+)的阳性率以及胆总管结石或肝内结石的发生率分别为27.9%、50.8%和14.8%。ECC患者中糖尿病、胆囊结石、胆总管结石或肝内结石以及既往胆囊切除术的发生率分别为18.6%、15.5%、18.6%和13.2%。ICC或ECC患者中上述所有因素的发生率均显著高于对照组（P<0.05）。与ECC患者相比，ICC患者的肝硬化发生率显著更高（P<0.05）。
我们的研究结果表明，胆总管结石或肝内结石、肝硬化和慢性HBV感染可能是肝内胆管癌的危险因素，而胆总管结石或肝内结石、糖尿病、胆囊结石、胆囊切除术史是肝外胆管癌的危险因素。
