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: 5.09). 05/2007; 120(9):1981-5. DOI: 10.1002/ijc.22375
Source: PubMed


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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Available from: Lori Sakoda, Feb 03, 2015
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    • "Fifty BTCs, 30 cholelithiasis and 30 healthy controls were randomly selected from the participants of the SBTCS, a population-based case-control study conducted by the Shanghai Cancer Institute and the National Cancer Institute between 1997 and 2001. As described in our previous reports [16,17,18,19,20,21,22], the BTCs were identified through a rapid reporting system and confirmed by a panel of clinicians, ultrasongraphers and pathologists through reviewing pathologic slides, CT, MRI and ERCP and medical records in a blind fashion. The blood samples of BTCs were collected after diagnosis but before treatment, and blood samples of cholelithiasis subjects and controls were drawn at interview. "
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    ABSTRACT: Biliary tract cancers (BTCs) are lethal malignancies currently lacking satisfactory methods for early detection and accurate diagnosis. Surface-enhanced laser desorption/ionization time-of-flight mass spectrometry (SELDI-TOF-MS) is a promising diagnostic tool for this disease. In this pilot study, sera samples from 50 BTCs and 30 cholelithiasis patients as well as 30 healthy subjects from a population-based case-control study were randomly grouped into training set (30 BTCs, 20 cholelithiasis and 20 controls), duplicate of training set, and blind set (20 BTCs, 10 cholelithiasis and 10 controls); all sets were analyzed on Immobilized Metal Affinity Capture ProteinChips via SELDI-TOF-MS. A decision tree classifier was built using the training set and applied to all test sets. The classification tree constructed with the 3,400, 4,502, 5,680, 7,598, and 11,242 mass-to-charge ratio (m/z) protein peaks had a sensitivity of 96.7% and a specificity of 85.0% when comparing BTCs with non-cancers. When applied to the duplicate set, sensitivity was 66.7% and specificity was 70.0%, while in the blind set, sensitivity was 95.0% and specificity was 75.0%. Positive predictive values of the training, duplicate, and blind sets were 82.9%, 62.5% and 79.2%, respectively. The agreement of the training and duplicate sets was 71.4% (Kappa = 0.43, u = 3.98, P < 0.01). The coefficient of variations based on 10 replicates of one sample for the five differential peaks were 15.8-68.8% for intensity and 0-0.05% for m/z. These pilot results suggest that serum protein profiling by SELDI-TOF-MS may be a promising approach for identifying BTCs but low assay reproducibility may limit its application in clinical practice.
    Cancers 09/2010; 2(3):1602-1616. DOI:10.3390/cancers2031602
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    • "Details of the study have been described previously (Hsing et al, 2007a, b, c, d; Andreotti et al, 2008; Hsing et al, 2008). A total of 361 women with biliary tract cancer (269 gallbladder, 92 bile duct) between 35 and 74 years of age were included. "
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    ABSTRACT: Parity has been linked to gallbladder cancer and gallstones, but the effects of other reproductive factors are less clear. We examined 361 incident biliary tract cancer cases, 647 biliary stone cases, and 586 healthy women in a population-based study in Shanghai. The effects of parity (odds ratios, OR(> or =3 vs 1 child)=2.0, 95% confidence interval (CI) 0.7-5.1), younger age at first birth (OR(per 1-year decrease)=1.2, 95% CI 0.99-1.6), and older age at menarche (OR(per 1-year increase)=1.4, 95% CI 1.1-1.8) on gallbladder cancer risk were more pronounced among women with stones, but the interactions were not significant. Our results provide support for high parity, younger age at first birth, and late age at menarche in the development of gallbladder cancer, particularly among women with biliary stones.
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    • "infection, especially HCV, and could be detected at an early stage, similar to HCC, by following up cases of chronic hepatitis and cirrhosis (Hsing et al., 2007). HCVrelated cirrhosis is major risk factor for CCA in Japanese patients (Kobayashi et al., 2000). "
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