Department of Comprehensive Treatment II, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China.
Eur J Cancer. 2010 Apr;46(6):1056-61. doi: 10.1016/j.ejca.2010.02.005. Epub 2010 Mar 4.
To evaluate potential risk factors for intrahepatic cholangiocarcinoma (ICC) and analyse clinicopathologic characteristics of ICC patients with seropositive hepatitis B surface antigen (HBsAg).
A retrospective case-control study was conducted. Cases were 317 ICC patients referred to the Eastern Hepatobiliary Surgery Hospital in China between 2003 and 2006. Controls were 634 healthy individuals. Adjusted odds ratios (ORs) were calculated in logistic regression analysis. Among 317 consecutively enrolled ICC patients, 154 patients were seropositive HBsAg (48.6%). We compared clinicopathologic characteristics of these patients (group I) with ICC patients seronegative for HBsAg (group II; n=163) and compared the age and sex distributions of patients in group I with randomly selected hepatitis B virus (HBV)-associated hepatocellular carcinoma (HCC) (group III; n=1,140).
Compared with the controls, ICC patients had a high prevalence of seropositive HBsAg, cirrhosis, hepatolithiasis and hepatic schistosomiasis. Compared with seronegative-HBsAg ICC patients, seropositive-HBsAg ICC patients were younger, more frequently male and had a higher proportion of abnormal aminotransferase and serum alpha-fetoprotein (AFP) level, histological inflammation and cirrhosis, right-lobe focus, poor tumour differentiation, tumour encapsulation and microvascular invasion; had a lower proportion of abnormal serum carbohydrate antigen 19-9 (CA19-9) level and lymphatic metastasis. The age and sex distribution profiles were nearly identical between seropositive-HBsAg ICC patients and HBV-associated HCC patients.
The HBV infection, cirrhosis, hepatolithiasis and hepatic schistosomiasis may be potential risk factors for ICC. HBV-associated ICC shares many clinicopathological similarities with HBV-associated HCC. The result indicated HBV-associated ICC and HBV-associated HCC may hold common disease process for carcinogenesis.
评估肝内胆管癌（ICC）的潜在危险因素，并分析乙肝表面抗原（HBsAg）阳性的 ICC 患者的临床病理特征。
进行了一项回顾性病例对照研究。病例为 2003 年至 2006 年期间在中国东方肝胆外科医院就诊的 317 例 ICC 患者。对照组为 634 名健康个体。采用 logistic 回归分析计算调整后的比值比（OR）。在连续纳入的 317 例 ICC 患者中，有 154 例 HBsAg 阳性（48.6%）。我们比较了这些患者（I 组）与 HBsAg 阴性的 ICC 患者（II 组；n=163）的临床病理特征，并比较了 I 组患者的年龄和性别分布与随机选择的乙型肝炎病毒（HBV）相关肝细胞癌（HCC）（III 组；n=1,140）。
与对照组相比，ICC 患者 HBsAg 阳性、肝硬化、胆石症和肝血吸虫病的患病率较高。与 HBsAg 阴性 ICC 患者相比，HBsAg 阳性 ICC 患者更年轻、更常为男性，且肝功能异常和血清甲胎蛋白（AFP）水平、组织学炎症和肝硬化、右叶病灶、肿瘤分化差、肿瘤包膜和微血管侵犯的比例较高，血清肿瘤相关碳水化合物抗原 19-9（CA19-9）水平和淋巴转移的比例较低。HBsAg 阳性 ICC 患者和 HBV 相关 HCC 患者的年龄和性别分布特征几乎相同。
HBV 感染、肝硬化、胆石症和肝血吸虫病可能是 ICC 的潜在危险因素。HBV 相关 ICC 与 HBV 相关 HCC 具有许多相似的临床病理特征。结果表明，HBV 相关 ICC 和 HBV 相关 HCC 可能具有共同的发病机制。
