Qu Zhenliang, Cui Naiqiang, Qin Mingfang, Wu Xianzhong
Department of Surgery, Tianjin Nankai Hospital, Tianjin Medical University, Tianjin, China.
Asia Pac J Clin Oncol. 2012 Mar;8(1):83-7. doi: 10.1111/j.1743-7563.2011.01466.x. Epub 2012 Jan 12.
Hepatitis virus B and C (HBV and HCV) are suggested to be risk factors for intrahepatic cholangiocarcinoma (ICC), but whether they are risk factors for extrahepatic cholangiocarcinoma (ECC) is disputed. To test the biomarkers in patients with ECC and further elucidate the relationship of HBV or HCV infection with ECC risk, we conducted a retrospective survey on hepatitis virus markers in patients with ECC.
A hospital-based case-control study was conducted to review prior infection with hepatitis virus and the seroprevalence of hepatitis virus markers in the patients with ECC or with benign biliary disease (BBD). HBV X antigen (HBxAg) was detected in the tissues by immunohistochemical staining.
A total of 305 patients with ECC and 480 with BBD were enrolled in this study. Compared with BBD patients, ECC patients had a higher prevalence of prior infection with HBV (6.2 vs 2.3%) and chronic HBV infection (9 vs 1.9%). The overall seropositive rate for HBV markers in the two groups was 22.6 versus 6% (P < 0.01) and for HBxAg detection it was 75 versus 26% (P < 0.001). The seroprevalence of anti-HCV was 4.3% in the EEC patients and 5.6% in BBD patients with no significant difference between them.
The high prevalence of HBV biomarkers in ECC strongly supports the notion that HBV infection may be a risk factor for ECC. The high frequency of HBxAg expression suggests its important role in the pathogenesis of bile duct neoplasm.
乙型和丙型肝炎病毒（HBV和HCV）被认为是肝内胆管癌（ICC）的危险因素，但它们是否为肝外胆管癌（ECC）的危险因素仍存在争议。为检测ECC患者的生物标志物并进一步阐明HBV或HCV感染与ECC风险的关系，我们对ECC患者的肝炎病毒标志物进行了一项回顾性调查。
开展一项基于医院的病例对照研究，以回顾ECC患者或良性胆道疾病（BBD）患者既往的肝炎病毒感染情况及肝炎病毒标志物的血清流行率。通过免疫组织化学染色检测组织中的HBV X抗原（HBxAg）。
本研究共纳入305例ECC患者和480例BBD患者。与BBD患者相比，ECC患者既往HBV感染（6.2%对2.3%）和慢性HBV感染（9%对1.9%）的患病率更高。两组HBV标志物的总体血清阳性率分别为22.6%和6%（P<0.01），HBxAg检测阳性率分别为75%和26%（P<0.001）。ECC患者中抗-HCV的血清流行率为4.3%，BBD患者中为5.6%，两者之间无显著差异。
ECC中HBV生物标志物的高患病率有力支持了HBV感染可能是ECC危险因素的观点。HBxAg表达的高频率表明其在胆管肿瘤发病机制中的重要作用。
