Department of Clinical Medicine, Sapienza University of Rome, Italy.
Dig Liver Dis. 2011 Jan;43(1):60-5. doi: 10.1016/j.dld.2010.05.002. Epub 2010 Jun 26.
Very few studies assessed cholangiocarcinoma clinical characteristics.
To evaluate the clinical characteristics of intra-hepatic (IH) and extra-hepatic (EH)-CCA.
We performed a national survey based on a questionnaire.
218 cholangiocarcinomas were observed (47% EH-CCA, 53% IH-CCA) with an age at the diagnosis higher for EH-CCA. Coexistence of cirrhosis or viral cirrhosis was more frequent in IH-CCA than EH-CCA. An incidental asymptomatic presentation occurred in 28% of IH-CCA vs 4% EH-CCA whilst, 74% EH-CCA vs 28% IH-CCA presented with jaundice. 91% of IH-CCA presented as a single intra-hepatic mass, whilst 50% of EH-CCA was peri-hilar. In the diagnostic work-up, 70% of all cholangiocarcinoma cases received at least 3 different imaging procedures. Tissue-proven diagnosis was obtained in 80% cholangiocarcinoma. Open surgery with curative intent was performed in 45% of IH-CCA and 29% EH-CCA. 18% IH-CCA vs 4% EH-CCA did not received treatment.
In Italy IH-CCA is managed as frequently as EH-CCA. In comparison to EH-CCA, IH-CCA occurs at younger age and is more frequently associated with cirrhosis and with an incidental asymptomatic presentation. In contrast, most EH-CCAs are jaundiced at the diagnosis. Cholangiocarcinoma diagnostic management is cost- and time-consuming with curative surgical treatment applicable more frequently in IH-CCA.
很少有研究评估胆管癌的临床特征。
评估肝内（IH）和肝外（EH）-CCA 的临床特征。
我们基于问卷进行了一项全国性调查。
观察到 218 例胆管癌（47%为 EH-CCA，53%为 IH-CCA），EH-CCA 的诊断年龄更高。IH-CCA 比 EH-CCA 更常合并肝硬化或病毒性肝硬化。IH-CCA 中有 28%为无症状偶发表现，而 EH-CCA 中仅有 4%为无症状偶发表现，74%的 EH-CCA 表现为黄疸，而 28%的 IH-CCA 表现为黄疸。91%的 IH-CCA 表现为单个肝内肿块，而 50%的 EH-CCA 为肝门周围。在诊断性检查中，所有胆管癌病例中有 70%接受了至少 3 种不同的影像学检查。80%的胆管癌获得了组织学诊断。有 45%的 IH-CCA 和 29%的 EH-CCA 进行了以治愈为目的的开放性手术。18%的 IH-CCA 未接受治疗。
在意大利，IH-CCA 的治疗与 EH-CCA 一样频繁。与 EH-CCA 相比，IH-CCA 发生在更年轻的年龄，更常与肝硬化相关，且更常表现为无症状偶发。相比之下，大多数 EH-CCAs 在诊断时即出现黄疸。胆管癌的诊断性治疗既耗时又费钱，可治愈的手术治疗在 IH-CCA 中更为适用。
