Biliary tract cancer and stones in relation to chronic liver conditions: A population-based study in Shanghai, China.

Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA.
International Journal of Cancer (Impact Factor: 6.2). 06/2007; 120(9):1981-5. DOI: 10.1002/ijc.22375
Source: PubMed

ABSTRACT Biliary tract cancers are relatively rare but fatal tumors. Apart from a close link with gallstones and cholangitis, risk factors for biliary tract cancer are obscure. Chronic liver conditions, including liver cirrhosis, have been linked to a higher risk of biliary tract cancer. In a population-based case-control study conducted in Shanghai, China, we investigated the relationships of a history of chronic hepatitis and liver cirrhosis as well as a family history of liver cancer with biliary tract cancer risk. The study included 627 patients with biliary tract cancers (368 gallbladder, 191 bile duct and 68 ampulla of Vater), 1,037 patients with biliary stones (774 gallbladder stones and 263 bile duct stones) and 959 healthy subjects randomly selected from the population. Bile duct cancer was associated with self-reports of chronic liver conditions, including a history of chronic hepatitis (OR = 2.0, 95% CI 0.9-4.4), liver cirrhosis (OR = 4.7, 95% CI 1.9-11.7) and a family history of primary liver cancer (OR = 2.0, 95% CI 1.0-3.9). The excess risk persisted after adjustment for gallstones and were more pronounced among subjects without gallstones (OR = 5.0, 95% CI 1.3-20.0 and OR = 4.9, 95% 2.0-12.2, respectively). History of liver conditions was also associated with an excess of biliary stones (OR = 1.9, 95% CI 1.2-3.0). No association was found for cancers of the gallbladder and ampulla of Vater. A history of chronic hepatitis and cirrhosis may be risk factors for extraheptic bile duct cancer. Given that chronic infection with hepatitis B virus (HBV) is the most common cause of liver disease in China, serologic markers of HBV need to be measured in future studies to examine the link between HBV and bile duct cancer.

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    ABSTRACT: Liver cancer is the most common cancer in males in Thailand and the third in females. A high incidence of cholangiocarcinoma (CCA) is estimated in the northeast of Thailand. Chronic infection with Opisthorchis viverrini (OV) is the major risk factor for development of CCA. It has been demonstrated that HCV infection is a risk factor for CCA in non - endemic area of OV infection. We examined the association of HBV and HCV and risk of CCA in the northeast Thailand. All cases of CCA were recruited between 1999 and 2001 from Nakhon Phanom provincial hospital and all community hospitals in the province. One control per case was selected, matched by sex, age (∓5 years) and residence. 106 case-control pairs were obtained. Anti-OV, HBsAg, and Anti HCV were determined by ELISA. Among 103 age-sex-place of residence matched case-control pairs, there were 7, 0, 0, 96 pairs for anti-HCV (+) case vs. (-) control, (+) case vs. (+) control, (-) case vs. (+) control and (-) case vs. (-) control combinations (OR=7/0). Among 106 matched pairs, there were 9, 2, 4, 91 pairs for the similar four combinations of HBsAg (OR=2.25 (95%CI: 0.63-10.0). If the subject had anti-HCV and/or HBsAg, the OR for CCA was 4.00 (95%CI: 1.29-16.4). Even after adjustment for anti-OV, risk for HBsAg and/or anti-HCV positive was still marginally increased with an OR of 4.69 although not reaching statistical significance (95%CI: 0.98-22.5). Hepatitis B and C virus infection may also play role in the development of CCA in northeast Thailand.
    Asian Pacific journal of cancer prevention: APJCP 01/2010; 11(4):985-8. · 1.50 Impact Factor
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    Meta Gene. 01/2014; 2:418–426.
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