Teerasarntipan Tongluk, Phuensan Pawat, Phathong Chonlada, Pinlaor Somchai, Mekaroonkamol Parit, Chaiteerakij Roongruedee
Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand.
Department of Medicine, Faculty of Medicine, Hospital and Ambulatory Medicine Unit, Chulalongkorn University, Bangkok 10330, Thailand.
Asian Biomed (Res Rev News). 2024 Oct 31;18(5):204-211. doi: 10.2478/abm-2024-0028. eCollection 2024 Oct.
Thailand has the world's highest prevalence of cholangiocarcinoma (CCA), especially in the endemic area of liver fluke infection. However, other regions of Thailand still have relatively high CCA prevalence.
We aimed to determine CCA risk factors in areas not endemic for OV infection.
A case--control study was performed at a referral center during December 2016-December 2017. We collected blood samples and information from CCA patients and identified them as cases. The control group comprised patients who visited a gastrointestinal clinic for colorectal cancer screening colonoscopy. Logistic regression analysis was used to determine risk factors for CCA.
Of 138 participants, infection rate was higher in the case than in the control group (57.1% vs. 36.1%, = 0.023). Male, infection, smoking, alcohol consumption, and biliary tract diseases were independent risk factors, whereas diabetes, obesity, and cirrhosis were not associated with CCA. By age and sex-adjusted analysis, chronic biliary tract diseases, especially choledochal cysts and smoking, were risk factors for CCA, with adjusted odds ratio (aOR) of 12.7 (95% confidence interval [CI]: 1.4-116.9) and 3.8 (95% CI: 1.3-11.8), respectively, while infection became insignificant risk for CCA (aOR 1.8, 95% CI: 0.8-4.1).
In contrast with endemic areas for infection, chronic biliary tract diseases and smoking are major risk factors, whereas infection has trivial contribution to the development of CCA.
泰国是世界上胆管癌（CCA）患病率最高的国家，尤其是在肝吸虫感染的流行地区。然而，泰国的其他地区CCA患病率仍然相对较高。
我们旨在确定华支睾吸虫（OV）感染非流行地区的CCA危险因素。
2016年12月至2017年12月在一家转诊中心进行了一项病例对照研究。我们收集了CCA患者的血液样本和信息，并将他们确定为病例。对照组包括因结直肠癌筛查结肠镜检查而就诊于胃肠诊所的患者。采用逻辑回归分析来确定CCA的危险因素。
在138名参与者中，病例组的感染率高于对照组（57.1%对36.1%，P = 0.023）。男性、华支睾吸虫感染、吸烟、饮酒和胆道疾病是独立的危险因素，而糖尿病、肥胖和肝硬化与CCA无关。通过年龄和性别调整分析，慢性胆道疾病，尤其是胆总管囊肿和吸烟是CCA的危险因素，调整后的优势比（aOR）分别为12.7（95%置信区间[CI]：1.4 - 116.9）和3.8（95%CI：1.3 - 11.8），而华支睾吸虫感染成为CCA的非显著危险因素（aOR 1.8，95%CI：0.8 - 4.1）。
与华支睾吸虫感染流行地区相比，慢性胆道疾病和吸烟是主要危险因素，而华支睾吸虫感染对CCA的发生贡献不大。
