Chang Jong-In, Lee Keol, Kim Dongwuk, Yang Ju-Ii, Park Jae Keun, Choi Kyu, Kang Soo Hoon, Lee Kwang Hyuck, Lee Kyu Taek, Lee Jong Kyun, Park Seon Mee, Park Joo Kyung
Division of Gastroenterology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Division of Gastroenterology, Department of Internal Medicine, Good Gangan Hospital, Busan, South Korea.
Front Med (Lausanne). 2021 May 28;8:675207. doi: 10.3389/fmed.2021.675207. eCollection 2021.
(CS) infection is considered a group 1 carcinogen of cholangiocarcinoma (CCA). There were very few studies regarding clinical characteristics of CS-associated CCA (CACC). This study aimed to investigate clinical characteristics of patients with CCA with or without CS infection. A total of 367 patients diagnosed with CCA who underwent diagnostic tests for CS infection were enrolled. CS infection was defined as follows: at least one positive serum ELISA test, skin test, stool microscopy, or bile microscopy. There were 95 (26%) patients with CS infections. The median follow-up duration was 14.9 months (range, 6.07-36.17). The following significant differences were noted among patients with CACC compared to non-CACC; diagnosis at younger age (median 62 years vs. 65 years, = 0.018), higher male to female ratio (83.2 vs. 61.8%, < 0.001), and residence in CS-endemic area (46.3 vs. 25.4%, = 0.014). Univariate analysis of prognostic factors indicated that tumor location, curative resection, tumor stage, and laboratory tests including CA 19-9, CEA, and bilirubin were significantly associated with overall survival, but CS infection was not. In multivariate analysis, tumor location, CEA, curative resection and tumor stage were identified as independent prognostic factors. Among patients under age 64, CACC group had lower survival rate than non-CACC group ( = 0.022). CACC had the following significant characteristics compared to non-CACC; diagnosis at younger age, higher male to female ratio, higher prevalence in CS endemic areas and poorer overall survival in patients under age 64.
华支睾吸虫(CS)感染被认为是胆管癌(CCA)的1类致癌物。关于华支睾吸虫相关胆管癌(CACC)临床特征的研究非常少。本研究旨在调查伴有或不伴有华支睾吸虫感染的胆管癌患者的临床特征。总共纳入了367例诊断为胆管癌且接受了华支睾吸虫感染诊断检测的患者。华支睾吸虫感染定义如下:血清ELISA检测、皮肤试验、粪便显微镜检查或胆汁显微镜检查中至少一项呈阳性。有95例(26%)患者感染了华支睾吸虫。中位随访时间为14.9个月(范围6.07 - 36.17个月)。与非CACC患者相比,CACC患者存在以下显著差异:诊断时年龄较轻(中位年龄62岁对65岁,P = 0.018)、男女比例较高(83.2%对61.8%,P < 0.001)以及居住在华支睾吸虫流行地区(46.3%对25.4%,P = 0.014)。预后因素的单因素分析表明,肿瘤位置、根治性切除、肿瘤分期以及包括CA 19 - 9、癌胚抗原(CEA)和胆红素在内的实验室检查与总生存期显著相关,但华支睾吸虫感染无关。多因素分析中,肿瘤位置、CEA、根治性切除和肿瘤分期被确定为独立的预后因素。在64岁以下的患者中,CACC组的生存率低于非CACC组(P = 0.022)。与非CACC相比,CACC具有以下显著特征:诊断时年龄较轻、男女比例较高、在华支睾吸虫流行地区患病率较高以及64岁以下患者的总生存期较差。