Di Stasi Vincenza, Contaldo Antonella, Birtolo Lucia Ilaria, Shahini Endrit
Center of Nutrition for the Research and the Care of Obesity and Metabolic Diseases, National Institute of Gastroenterology IRCCS "Saverio de Bellis", Castellana Grotte, 70013 Bari, Italy.
Gastroenterology Unit, National Institute of Gastroenterology IRCCS "Saverio de Bellis", Castellana Grotte, 70013 Bari, Italy.
Cancers (Basel). 2024 Oct 9;16(19):3432. doi: 10.3390/cancers16193432.
BTC overall incidence is globally increasing. CCA, including its subtypes, is a form of BTC. MetS, obesity, MASLD, and diabetes are all linked to CCA in interconnected ways. The link between obesity and CCA is less well-defined in Eastern countries as compared to Western. Although more research is needed to determine the relationship between MASLD and extrahepatic CCA (eCCA), MASLD may be a concurrent risk factor for intrahepatic CCA, particularly in populations with established or unidentified underlying liver disease. Interestingly, the risk of biliary tract cancer (BTC) seemed to be higher in patients with shorter diabetes durations who were not treated with insulin. Therefore, early detection and prevention of chronic liver disease, as well as additional intervention studies, will undoubtedly be required to determine whether improvements to MetS, weight loss, and diabetes therapy can reduce the risk and progression of BTC. However, further studies are needed to understand how reproductive hormones are involved in causing BTC and to develop consistent treatment for patients. Finally, it is critical to carefully assess the cardiological risk in BTC patients due to their increased intrinsic cardiovascular risk, putting them at risk for thrombotic complications, cardiovascular death, cardiac metastasis, and nonbacterial thrombotic endocarditis. This review aimed to provide an updated summary of the relation between the abovementioned cardio-metabolic conditions and BTC.
胆管癌（BTC）的总体发病率在全球范围内呈上升趋势。胆管癌（CCA），包括其亚型，是BTC的一种形式。代谢综合征（MetS）、肥胖、代谢相关脂肪性肝病（MASLD）和糖尿病都以相互关联的方式与CCA相关。与西方国家相比，肥胖与CCA之间的联系在东方国家尚不明确。虽然需要更多研究来确定MASLD与肝外CCA（eCCA）之间的关系，但MASLD可能是肝内CCA的并发危险因素，尤其是在患有已确诊或未确诊潜在肝病的人群中。有趣的是，未接受胰岛素治疗且糖尿病病程较短的患者患胆管癌（BTC）的风险似乎更高。因此，无疑需要对慢性肝病进行早期检测和预防，以及开展更多干预研究，以确定改善MetS、减轻体重和糖尿病治疗是否能降低BTC的风险和进展。然而，还需要进一步研究来了解生殖激素如何参与导致BTC，并为患者制定一致的治疗方案。最后，由于BTC患者的内在心血管风险增加，使其面临血栓并发症、心血管死亡、心脏转移和非细菌性血栓性心内膜炎的风险，因此仔细评估他们的心血管风险至关重要。本综述旨在提供上述心血管代谢疾病与BTC之间关系的最新总结。
