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胆管癌发生的超声预测因素：来自一个地方病流行区的队列研究。

Sonographic Predictors for Developing Cholangiocarcinoma: A Cohort Study from an Endemic Area.

作者信息

Thanakijsombat Natcha, Soonklang Kamonwan, Hiranrat Pantajaree, Limpisook Poemporn, Siripongsakun Surachate

机构信息

Sonographer School, Faculty of Health Science Technology, Chulabhorn Royal Academy, Bangkok, Thailand.

Department of Emergency Medicine, Police General Hospital, Bangkok, Thailand.

出版信息

Asian Pac J Cancer Prev. 2024 Dec 1;25(12):4229-4236. doi: 10.31557/APJCP.2024.25.12.4229.

DOI:10.31557/APJCP.2024.25.12.4229
PMID:39733414
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12008351/
Abstract

BACKGROUND AND AIM

Cholangiocarcinoma (CCA) is an aggressive malignancy with a poor prognosis. Bile duct and peribiliary changes related to CCA may present on ultrasound (US) findings. This study aims to evaluate US findings that could be used as predictors for developing CCA through our surveillance program in an endemic area of Thailand.

METHODS

The study population was 4,337 villagers in Northern Thailand with a 5-year abdominal US surveillance. Patient demographics data and ultrasound findings of calcifications/granulomas, periductal fibrosis, and diffuse bile duct dilatation were included. A logistic regression model was used to determine significant predictors.

RESULTS

There were 4,225 people included with an average age of 45.49±7.66 years. Prevalence of calcifications/granulomas, periductal fibrosis, and diffuse bile duct dilatation detected on baseline sonographic surveillance was 11.7%, 20.5%, and 11.3%, respectively. The univariate analysis for significant predictors for CCA include age (Relative Risk; RR = 1.12), family history of CCA (RR = 2.29), periductal fibrosis (RR=2.38), and diffuse bile duct dilatation  (RR = 7.59). The multivariate analysis the independent predictors were age (RR = 1.12), family history of CCA (RR = 1.92), and diffuse bile duct dilatation (RR = 5.94), respectively.

CONCLUSIONS

The sonographic predictor for CCA surveillance in endemic areas is diffuse bile duct dilatation.  Age and family history of CCA are also helpful clinical markers.

摘要

背景与目的

胆管癌（CCA）是一种侵袭性恶性肿瘤，预后较差。与CCA相关的胆管及胆管周围改变可能在超声（US）检查结果中呈现。本研究旨在评估在泰国一个地方病流行区通过我们的监测项目可作为CCA发生预测指标的超声检查结果。

方法

研究人群为泰国北部4337名村民，进行了为期5年的腹部超声监测。纳入患者人口统计学数据以及钙化/肉芽肿、导管周围纤维化和弥漫性胆管扩张的超声检查结果。采用逻辑回归模型确定显著预测指标。

结果

共纳入4225人，平均年龄45.49±7.66岁。基线超声监测发现的钙化/肉芽肿、导管周围纤维化和弥漫性胆管扩张的患病率分别为11.7%、20.5%和11.3%。CCA显著预测指标的单因素分析包括年龄（相对风险；RR = 1.12）、CCA家族史（RR = 2.29）、导管周围纤维化（RR = 2.38）和弥漫性胆管扩张（RR = 7.59）。多因素分析中独立预测指标分别为年龄（RR = 1.12）、CCA家族史（RR = 1.92）和弥漫性胆管扩张（RR = 5.94）。

结论

地方病流行区CCA监测的超声预测指标是弥漫性胆管扩张。年龄和CCA家族史也是有用的临床标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fae9/12008351/846ad06a1d7c/APJCP-25-4229-g007.jpg
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本文引用的文献

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Cost-Effectiveness Analysis of Ultrasound Surveillance for Cholangiocarcinoma in an Endemic Area of Thailand.泰国胆管癌高发地区超声筛查的成本效益分析。
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Risk Factors for Opisthorchis Viverrini Infection: A Systematic Review.华支睾吸虫感染的危险因素：系统评价。
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A comparison of the proportion of early stage cholangiocarcinoma found in an ultrasound-screening program compared to walk-in patients.
超声筛查项目中与门诊患者相比早期胆管癌的检出比例比较。
HPB (Oxford). 2020 Jun;22(6):874-883. doi: 10.1016/j.hpb.2019.10.010. Epub 2019 Oct 26.
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Association between periductal fibrosis and bile duct dilatation among a population at high risk of cholangiocarcinoma: a cross-sectional study of cholangiocarcinoma screening in Northeast Thailand.在泰国东北部进行的胆管癌筛查的一项横断面研究中，高风险人群中胆管周围纤维化与胆管扩张之间的关联。
BMJ Open. 2019 Mar 20;9(3):e023217. doi: 10.1136/bmjopen-2018-023217.
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Premalignant lesions of cholangiocarcinoma: characteristics on ultrasonography and MRI.胆管癌的癌前病变：超声和 MRI 的特征。
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Cholangiocarcinoma Trends, Incidence, and Relative Survival in Khon Kaen, Thailand From 1989 Through 2013: A Population-Based Cancer Registry Study.泰国孔敬府胆管癌的趋势、发病率和相对生存率：1989 年至 2013 年的一项基于人群的癌症登记研究。
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Risk Factors for Cholangiocarcinoma in Thailand: A Systematic Review and Meta-Analysis.泰国胆管癌的危险因素：系统评价与荟萃分析
Asian Pac J Cancer Prev. 2018 Mar 27;19(3):605-614. doi: 10.22034/APJCP.2018.19.3.605.
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BMC Cancer. 2016 Jun 2;16:346. doi: 10.1186/s12885-016-2390-2.