Rustagi Tarun, Dasanu Constantin A
Department of Internal Medicine, University of Connecticut, Farmington, CT 06032, USA.
J Gastrointest Cancer. 2012 Jun;43(2):137-47. doi: 10.1007/s12029-011-9284-y.
Far-ranging variation in the incidence of gallbladder cancer (GBC) and cholangiocarcinoma (CCA) in different geographic regions on the globe may reflect the risk factor distribution for these tumors
The authors give a comprehensive review on the known risk factors for GBC and CCA, and analyze both similarities and differences between the risk factors for the two main types of biliary cancer
Leading risk factors for GBC include gallstones, female gender, and advancing age. Primary sclerosing cholangitis, nitrosamine exposure, choledochal cysts, Clonorchis sinensis and Opisthorchis viverrini represent important risk factors for CCA, although a specific risk factor cannot be identified for many patients. While both cancers affect mostly individuals in their sixth decade or older, CCA has a male predominance and GBC--a predilection for females. Although the current level of understanding of the molecular pathogenesis of GBC and CCA at the interface with specific risk factors is significantly lower than for other gastrointestinal malignancies, it continues to evolve and may soon open new avenues for the therapy of biliary cancers.
全球不同地理区域胆囊癌（GBC）和胆管癌（CCA）发病率差异很大，这可能反映了这些肿瘤的危险因素分布情况。
作者对已知的GBC和CCA危险因素进行了全面综述，并分析了这两种主要类型胆管癌危险因素之间的异同。
GBC的主要危险因素包括胆结石、女性性别和年龄增长。原发性硬化性胆管炎、亚硝胺暴露、胆总管囊肿、华支睾吸虫和猫后睾吸虫是CCA的重要危险因素，尽管许多患者无法确定具体的危险因素。虽然这两种癌症主要影响60岁及以上的个体，但CCA以男性为主，而GBC则更青睐女性。尽管目前对GBC和CCA与特定危险因素相关的分子发病机制的了解程度明显低于其他胃肠道恶性肿瘤，但仍在不断发展，可能很快会为胆管癌的治疗开辟新途径。
