nach oben

Erschienen in:

01.05.2011 | Hepatobiliary Tumors

Evaluation of Risk Factors and Clinicopathologic Features for Intrahepatic Cholangiocarcinoma in Southern China: A Possible Role of Hepatitis B Virus

verfasst von: Ning-fu Peng, MMed, Le-qun Li, PhD, Xiao Qin, MMed, Ya Guo, PhD, Tao Peng, PhD, Kai-yin Xiao, PhD, Xi-gang Chen, MMed, Yu-feng Yang, MMed, Zhi-xiong Su, PhD, Bin Chen, PhD, Ming Su, PhD, Lu-nan Qi, MMed

Erschienen in: Annals of Surgical Oncology | Ausgabe 5/2011

Einloggen, um Zugang zu erhalten

Abstract

Background

Recent efforts suggest an etiologic role of hepatitis B virus (HBV) infection in intrahepatic cholangiocarcinoma (ICC) and the involvement of hepatic progenitor cell in ICC development, without definitive conclusions. This case-control study was undertaken to investigate risk factors for ICC, and clinicopathological features of HBV-associated ICC were analyzed.

Methods

The report comprised 98 patients with pathologically confirmed ICC and 196 healthy control subjects. Logistic regression was used to determine odds ratios and 95% confidence intervals. The sex and age distributions of HBV-related and unrelated ICC patients were compared respectively with those of 882 HBV-associated hepatocellular carcinoma patients from a random selection, and the clinicopathological data of 62 ICC patients with or without HBV infection undergoing surgical resection were compared.

Results

There was an association between ICC and each of HBV infection, liver cirrhosis, hepatolithiasis, and liver fluke infestation with the odds ratios (95% confidence intervals) of 2.75 (1.27–5.95), 8.42 (2.50–28.37), 22.81 (7.16–72.68), and 3.55 (1.60–7.89), respectively, with a marked synergism of cirrhosis and HBV infection (20.67; 5.40–79.06). Compared with HBV-unrelated ICC patients, HBV-related ICC patients were more common in male and younger subjects, had a higher incidence of abnormal serum alfa-fetoprotein level, cirrhosis, and neutrophilic infiltration, and had a lower proportion of elevated carbohydrate antigen 19-9 (CA19-9) values.

Conclusions

The independent association of HBV infection with ICC, synergy between cirrhosis and HBV infection, and some clinicopathological similarities between HBV-related ICC and hepatocellular carcinoma suggests that both may share similar or common tumorigenic process and may possibly originate from malignant transformation of hepatic progenitor cell.

Ben-Menachem T. Risk factors for cholangiocarcinoma. Eur J Gastroenterol Hepatol. 2007;19:615–7.PubMedCrossRef

Blechacz B, Gores GJ. Cholangiocarcinoma: advances in pathogenesis, diagnosis, and treatment. Hepatology. 2008;48:308–21.PubMedCrossRef

Khan SA, Taylor-Robinson SD, Toledano MB, et al. Changing international trends in mortality rates for liver, biliary and pancreatic tumours. J Hepatol. 2002;37:806–13.PubMedCrossRef

Welzel TM, McGlynn KA, Hsing AW, O’Brien TR, Pfeiffer RM. Impact of classification of hilar cholangiocarcinomas (Klatskin tumors) on the incidence of intra- and extrahepatic cholangiocarcinoma in the United States. J Natl Cancer Inst. 2006;98:873–5.PubMedCrossRef

McGlynn KA, Tarone RE, El-Serag HB. A comparison of trends in the incidence of hepatocellular carcinoma and intrahepatic cholangiocarcinoma in the United States. Cancer Epidemiol Biomarkers Prev. 2006;15:1198–203.PubMedCrossRef

Wang WL, Gu GY, Hu M. Expression and significance of HBV genes and their antigens in human primary intrahepatic cholangiocarcinoma. World J Gastroenterol. 1998;4:392–6.PubMed

Yamamoto S, Kubo S, Hai S, et al. Hepatitis C virus infection as a likely etiology of intrahepatic cholangiocarcinoma. Cancer Sci. 2004;95:592–5.PubMedCrossRef

Perumal V, Wang J, Thuluvath P, Choti M, Torbenson M. Hepatitis C and hepatitis B nucleic acids are present in intrahepatic cholangiocarcinomas from the United States. Hum Pathol. 2006;37:1211–6.PubMedCrossRef

Welzel TM, Graubard BI, El-Serag HB, et al. Risk factors for intrahepatic and extrahepatic cholangiocarcinoma in the United States: a population-based case-control study. Clin Gastroenterol Hepatol. 2007;5:1221–8.PubMedCrossRef

10.

Lee CH, Chang CJ, Lin YJ, et al. Viral hepatitis-associated intrahepatic cholangiocarcinoma shares common disease processes with hepatocellular carcinoma. Br J Cancer. 2009;100:1765–70.PubMedCrossRef

11.

Zhou H, Wang H, Zhou D, et al. Hepatitis B virus-associated intrahepatic cholangiocarcinoma and hepatocellular carcinoma may hold common disease process for carcinogenesis. Eur J Cancer. 2010;46:1056–61.PubMedCrossRef

12.

Tanaka S, Yamamoto T, Tanaka H, et al. Potentiality of combined hepatocellular and intrahepatic cholangiocellular carcinoma originating from a hepatic precursor cell: immunohistochemical evidence. Hepatol Res. 2005;32:52–7.PubMedCrossRef

13.

Roskams T. Liver stem cells and their implication in hepatocellular and cholangiocarcinoma. Oncogene. 2006;25:3818–22.PubMedCrossRef

14.

Zhang F, Chen XP, Zhang W, et al. Combined hepatocellular cholangiocarcinoma originating from hepatic progenitor cells: immunohistochemical and double-fluorescence immunostaining evidence. Histopathology. 2008;52:224–32.PubMedCrossRef

15.

Hadler SC, Murphy BL, Schable CA, et al. Epidemiological analysis of the significance of low-positive test results for antibody to hepatitis B surface and core antigens. J Clin Microbiol. 1984;19:521–5.PubMed

16.

Liver Cancer Study Group of Japan. Intrahepatic cholangiocarcinoma, macroscopic typing. In: Okamoto E, eds. Classification of Primary Liver Cancer. Tokyo: Kanehara, 1997:6–7.

17.

Yu SH, Kawanaka M, Li XM, et al. Epidemiological investigation on Clonorchis sinensis in human population in an area of South China. Jpn J Infect Dis. 2003;56:168–71.PubMed

18.

Lin R, Li X, Lan C, Yu S, Kawanaka M. Investigation on the epidemiological factors of Clonorchis sinensis infection in an area of south China. Southeast Asian J Trop Med Public Health. 2005;36:1114–7.PubMed

19.

Zhuo J, Tao G, Ebrahim SH, et al. The relationship of hepatitis B virus infection between adults and their children in Guangxi Province, China. J Hepatol. 2000;33:628–31.PubMedCrossRef

20.

Yeh FS, Yu MC, Mo CC, et al. Hepatitis B virus, aflatoxins, and hepatocellular carcinoma in southern Guangxi, China. Cancer Res. 1989;49:2506–9.PubMed

21.

Marrero CR, Marrero JA. Viral hepatitis and hepatocellular carcinoma. Arch Med Res. 2007;38:612–20.PubMedCrossRef

22.

Berasain C, Castillo J, Perugorria MJ, et al. Inflammation and liver cancer: new molecular links. Ann N Y Acad Sci. 2009;1155:206–21.PubMedCrossRef

23.

De Alwis N, Hudson G, Burt AD, Day CP, Chinnery PF. Human liver stem cells originate from the canals of Hering. Hepatology. 2009;50:992–3.PubMedCrossRef

24.

Gaudio E, Carpino G, Cardinale V, et al. New insights into liver stem cells. Dig Liver Dis. 2009;41:455–62.PubMedCrossRef

25.

Fellous TG, Islam S, Tadrous PJ, et al. Locating the stem cell niche and tracing hepatocyte lineages in human liver. Hepatology. 2009;49:1655–63.PubMedCrossRef

26.

Bhagat V, Javle M, Yu J, et al. Combined hepatocholangiocarcinoma: case-series and review of literature. Int J Gastrointest Cancer. 2006;37:27–34.PubMedCrossRef

27.

Inaba K, Suzuki S, Sakaguchi T, et al. Double primary liver cancer (intrahepatic cholangiocarcinoma and hepatocellular carcinoma) in a patient with hepatitis C virus-related cirrhosis. J Hepatobiliary Pancreat Surg. 2007;14:204–9.PubMedCrossRef

28.

Chen F, Li S, Castranova V. Overlapping signature genes between hepatocellular carcinoma and intrahepatic cholangiocarcinoma. Eur J Gastroenterol Hepatol. 2009;21:1320–1.PubMedCrossRef

29.

Wands J. Hepatocellular carcinoma and sex. N Engl J Med. 2007;357:1974–6.PubMedCrossRef

30.

Wang N, Zheng Y, Yu X, et al. Sex-modified effect of hepatitis B virus infection on mortality from primary liver cancer. Am J Epidemiol. 2009;169:990–5.PubMedCrossRef

31.

Spear BT. Alpha-fetoprotein gene regulation: lessons from transgenic mice. Semin Cancer Biol. 1999;9:109–16.PubMedCrossRef

32.

Ishii T, Yasuchika K, Fujii H, et al. In vitro differentiation and maturation of mouse embryonic stem cells into hepatocytes. Exp Cell Res. 2005;309:68–77.PubMedCrossRef

33.

Ishii T, Fukumitsu K, Yasuchika K, et al. Effects of extracellular matrixes and growth factors on the hepatic differentiation of human embryonic stem cells. Am J Physiol Gastrointest Liver Physiol. 2008;295:G313–21.PubMedCrossRef

34.

Liver Cancer Study Group of Japan. Primary liver cancer in Japan. Clinicopathologic features and results of surgical treatment. Ann Surg 1990;211:277–87.

35.

Ishikawa K, Sasaki A, Haraguchi N, Yoshikawa Y, Mori M. A case of an alpha-fetoprotein-producing intrahepatic cholangiocarcinoma suggests probable cancer stem cell origin. Oncologist. 2007;12:320–4.PubMedCrossRef

36.

Ishii T, Yasuchika K, Suemori H, et al. Alpha-fetoprotein producing cells act as cancer progenitor cells in human cholangiocarcinoma. Cancer Lett. 2010;294:25–34.PubMedCrossRef

37.

Yamamoto M, Ariizumi S, Otsubo T, et al. Intrahepatic cholangiocarcinoma diagnosed preoperatively as hepatocellular carcinoma. J Surg Oncol. 2004;87:80–3.PubMedCrossRef

38.

Sasaki M, Tsuneyama K, Ishikawa A, Nakanuma Y. Intrahepatic cholangiocarcinoma in cirrhosis presents granulocyte and granulocyte-macrophage colony-stimulating factor. Hum Pathol. 2003;34:1337–44.PubMedCrossRef

39.

Nakanuma Y, Sasaki M, Ikeda H, et al. Pathology of peripheral intrahepatic cholangiocarcinoma with reference to tumorigenesis. Hepatol Res. 2008;38:325–34.PubMedCrossRef

40.

Yamanaka N, Okamoto E, Ando T, et al. Clinicopathologic spectrum of resected extraductal mass-forming intrahepatic cholangiocarcinoma. Cancer. 1995;76:2449–56.PubMedCrossRef

41.

Shirabe K, Shimada M, Harimoto N, et al. Intrahepatic cholangiocarcinoma: its mode of spreading and therapeutic modalities. Surgery. 2002;131:S159–64.PubMedCrossRef

42.

Zhou XD, Tang ZY, Fan J, et al. Intrahepatic cholangiocarcinoma: report of 272 patients compared with 5,829 patients with hepatocellular carcinoma. J Cancer Res Clin Oncol. 2009;135:1073–80.PubMedCrossRef

43.

Isaji S, Kawarada Y, Taoka H, et al. Clinicopathological features and outcome of hepatic resection for intrahepatic cholangiocarcinoma in Japan. J Hepatobiliary Pancreat Surg. 1999;6:108–16.PubMedCrossRef

44.

Shimada K, Sano T, Sakamoto Y, et al. Surgical outcomes of the mass-forming plus periductal infiltrating types of intrahepatic cholangiocarcinoma: a comparative study with the typical mass-forming type of intrahepatic cholangiocarcinoma. World J Surg. 2007;31:2016–22.PubMedCrossRef

45.

Sasaki A, Aramaki M, Kawano K, et al. Intrahepatic peripheral cholangiocarcinoma: mode of spread and choice of surgical treatment. Br J Surg. 1998;85:1206–9.PubMedCrossRef

46.

Hu KQ. Occult hepatitis B virus infection and its clinical implications. J Viral Hepat. 2002;9:243–57.PubMedCrossRef

47.

Torbenson M, Thomas DL. Occult hepatitis B. Lancet Infect Dis. 2002;2:479–86.PubMedCrossRef

48.

Chemin I, Trepo C. Clinical impact of occult HBV infections. J Clin Virol. 2005;34(Suppl 1):S15–21.PubMedCrossRef

49.

Lupberger J, Hildt E. Hepatitis B virus–induced oncogenesis. World J Gastroenterol. 2007;13:74–81.PubMed

Titel: Evaluation of Risk Factors and Clinicopathologic Features for Intrahepatic Cholangiocarcinoma in Southern China: A Possible Role of Hepatitis B Virus
verfasst von: Ning-fu Peng, MMed
Le-qun Li, PhD
Xiao Qin, MMed
Ya Guo, PhD
Tao Peng, PhD
Kai-yin Xiao, PhD
Xi-gang Chen, MMed
Yu-feng Yang, MMed
Zhi-xiong Su, PhD
Bin Chen, PhD
Ming Su, PhD
Lu-nan Qi, MMed
Publikationsdatum: 01.05.2011
Verlag: Springer-Verlag
Erschienen in: Annals of Surgical Oncology / Ausgabe 5/2011
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-010-1458-5

Neu im Fachgebiet Chirurgie

Echinokokkose medikamentös behandeln oder operieren?

06.05.2024 DCK 2024 Kongressbericht

Die Therapie von Echinokokkosen sollte immer in spezialisierten Zentren erfolgen. Eine symptomlose Echinokokkose kann – egal ob von Hunde- oder Fuchsbandwurm ausgelöst – konservativ erfolgen. Wenn eine Op. nötig ist, kann es sinnvoll sein, vorher Zysten zu leeren und zu desinfizieren.

Recycling im OP – möglich, aber teuer

05.05.2024 DCK 2024 Kongressbericht

Auch wenn sich Krankenhäuser nachhaltig und grün geben – sie tragen aktuell erheblich zu den CO₂-Emissionen bei und produzieren jede Menge Müll. Ein Pilotprojekt aus Bonn zeigt, dass viele Op.-Abfälle wiederverwertet werden können.

Im OP der Zukunft läuft nichts mehr ohne Kollege Roboter

04.05.2024 DCK 2024 Kongressbericht

Der OP in der Zukunft wird mit weniger Personal auskommen – nicht, weil die Technik das medizinische Fachpersonal verdrängt, sondern weil der Personalmangel es nötig macht.

Nur selten Nachblutungen nach Abszesstonsillektomie

03.05.2024 Tonsillektomie Nachrichten

In einer Metaanalyse von 18 Studien war die Rate von Nachblutungen nach einer Abszesstonsillektomie mit weniger als 7% recht niedrig. Nur rund 2% der Behandelten mussten nachoperiert werden. Die Therapie scheint damit recht sicher zu sein.

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Aktuelle BDC Leitlinien-Webinare

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare

CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare

CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske

Dr. med. Benjamin Meyknecht

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare

CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric

Live-Webinar "Chronische Unterbauch- und Viszeralschmerzen in der Praxis managen"

Springer Medizin

Evaluation of Risk Factors and Clinicopathologic Features for Intrahepatic Cholangiocarcinoma in Southern China: A Possible Role of Hepatitis B Virus