Descriptive epidemiology of cholangiocarcinoma in Italy
ABSTRACT Very little data exist on the epidemiology of cholangiocarcinoma in Italy.
We focus on the descriptive epidemiology of cholangiocarcinoma in Italy.
Data on incidence were obtained from the Italian Association of Tumour Registries while mortality data were obtained from the Italian National Institute of Statistics.
A progressive increase of incidence with age was seen for extra-hepatic, intra-hepatic and not otherwise specified cholangiocarcinoma. Crude incidence rates were higher for extra-hepatic cholangiocarcinoma than those for intra-hepatic cholangiocarcinoma and in men compared to women. An increasing incidence trend was observed, from 1988 to 2005, for both extra-hepatic- and intra-hepatic cholangiocarcinoma with a 3-6% yearly increase and with a rate of increase higher for men than for women and for intra-hepatic- than for extra-hepatic cholangiocarcinoma. For intra-hepatic cholangiocarcinoma, the mortality rates progressively increased from 0.15 per million in 1980 to 5.9 per million in 2003, when mortality for this cancer surpassed extra-hepatic cholangiocarcinoma. Mortality rates for extra-hepatic cholangiocarcinoma showed an increasing trend from 1980 to 1994 but, in contrast to intra-hepatic cholangiocarcinoma, a stable or slightly decreasing trend from 1995 to 2003 was observed.
In Italy, cholangiocarcinoma showed a progressive increase in incidence and mortality in the last two decades mainly in intra-hepatic cholangiocarcinoma.
- SourceAvailable from: Timothy M PawlikJournal of Hepatology 06/2014; DOI:10.1016/j.jhep.2014.01.021 · 10.40 Impact Factor
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ABSTRACT: Purpose An increasing incidence of cholangiocarcinoma (CCA) has been reported in Western countries, but evidence is lacking in Asia. We investigated the incidence of CCA in a nationwide cohort. Patients and methods We conducted a nationwide cohort study based on data from the Taiwan National Health Insurance Research Database (NHIRD) between 1998 and 2008. A total of 6,491 CCA patients were recruited. Adjusted incidences, cumulative incidences, and stratified analyses were used to detect trends regarding CCA incidence in Taiwan. Results The incidence of CCA increased by 2.01-fold, from 1.79 in 1998 to 3.60 in 2008 per 100,000 persons. For extrahepatic CCA, the incidence increased by 1.5-fold from 0.48 to 0.73 per 100,000. Intrahepatic CCA increased by 3.0-fold from 0.72 to 2.19 per 100,000. The rising incidence of CCA was observed across all sexes and ages, especially in those older than 65 years of age. The proportion of CCA patients who underwent surgery and the overall survival rates remained stable. Conclusions The incidence of both intrahepatic and extrahepatic CCA increased significantly between 1998 and 2008. Rising trends were observed among different ages and sexes, especially in the elderly population.Hepatology International 03/2012; 7(1). DOI:10.1007/s12072-012-9369-0 · 2.47 Impact Factor
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ABSTRACT: Prostate apoptosis response-4 (Par-4) is a tumor suppressor protein that sensitizes cells to apoptosis; therefore, Par-4 modulation has therapeutic potential. No data currently exist on Par-4 expression in cholangiocarcinoma (CCA). We evaluated the expression of Par-4 in normal and neoplastic cholangiocytes and the effects of its pharmacological or genetic modulation. The study was performed in human and rat liver, CCA patient biopsies, and two CCA cell lines. PAR-4 was expressed in normal rat and human cholangiocytes, but its expression levels decreased in both human CCA and CCA cell lines. In both intrahepatic and extrahepatic CCA, Par-4 expression (as shown by immunohistochemistry) was inversely correlated with markers of proliferation (eg, proliferating cellular nuclear antigen) and directly correlated with apoptotic markers (eg, Bax and Bax/BCL2 ratio). Par-4 expression was decreased during CCA cell proliferation but was enhanced after apoptosis induction. Pharmacological induction of Par-4 expression in CCA cell lines by diindolymethane or withaferin A promoted activation of apoptosis and inhibition of proliferation. In contrast, specific Par-4 silencing by small-interfering RNA determined activation of CCA cell line proliferation. Par-4 is expressed in rat and human cholangiocytes and is down-regulated in both human CCA and CCA cell lines. Par-4 protein levels decrease during cell proliferation but increase during apoptosis. Pharmacological or genetic induction of Par-4 determines apoptosis of CCA cells, suggesting Par-4 targeting as a CCA treatment strategy.American Journal Of Pathology 10/2010; 177(4):1779-90. DOI:10.2353/ajpath.2010.091171 · 4.60 Impact Factor