Cholangiocarcinoma Screening and Care Program (CASCAP), Khon Kaen University, Khon Kaen, Thailand; Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand; Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
Cholangiocarcinoma Screening and Care Program (CASCAP), Khon Kaen University, Khon Kaen, Thailand; Cholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, Thailand; Department of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
HPB (Oxford). 2020 Jun;22(6):874-883. doi: 10.1016/j.hpb.2019.10.010. Epub 2019 Oct 26.
Patients with cholangiocarcinoma (CCA) usually have no specific symptoms until an advance stage of the disease and curative treatment is not possible. Patients with early stage, operable disease can be found using ultrasonography (US). A US-screening program was implemented in Thailand where CCA incidence is the highest worldwide. Here we evaluate the effectiveness of the program by comparing the proportion of individuals with early stage CCA in the screening group with that of the walk-in group presenting at hospitals with clinical symptoms.
All patients had a pathological diagnosis of CCA. The difference in the proportions and the 95% confidence interval (CI) were obtained using binomial regression.
Of the 762 histologically proven CCA cases, 161 were from the screening group and 601 from the walk-in group. The proportion of early stage CCA (stages 0 to II) diagnosed was 84.5% in the screening and 21.6% in the walk-in groups. After adjustment age, gender, and liver fluke infection, there was a significantly higher proportion (P < 0.001) and higher chance (P < 0.001) of having early stage CCA in the screening group than in the walk-in group.
US-screening is an effective tool for detecting early stage, operable CCA in high incidence areas.
胆管癌（CCA）患者在疾病晚期通常没有特定的症状，无法进行治愈性治疗。早期、可手术的疾病患者可以通过超声检查（US）发现。在 CCA 发病率居世界首位的泰国，实施了一项 US 筛查计划。在此，我们通过比较筛查组中早期 CCA 患者的比例与因临床症状就诊于医院的门诊组中早期 CCA 患者的比例，评估该计划的有效性。
所有患者均经病理诊断为 CCA。使用二项式回归获得比例差异及其 95%置信区间（CI）。
在 762 例经组织学证实的 CCA 病例中，161 例来自筛查组，601 例来自门诊组。筛查组中早期 CCA（0 期至 II 期）的诊断比例为 84.5%，门诊组为 21.6%。调整年龄、性别和肝吸虫感染后，筛查组中早期 CCA 的比例（P<0.001）和发生早期 CCA 的机会（P<0.001）均显著高于门诊组。
US 筛查是在高发地区检测早期、可手术 CCA 的有效工具。
