Cholangiocarcinoma and Clonorchis sinensis infection: a case-control study in Korea.
OBJECTIVE
The authors conducted a hospital-based case-control study to evaluate the role of Clonorchis sinensis infection as a risk factor for the development of cholangiocarcinoma (CC), including extrahepatic CC, in Korea.


METHODS
Cases of 185 patients with CC (intrahepatic, 51; hilar, 53; and distal extrahepatic, 81) and matched controls underwent stool microscopy, pathological examinations, serologic test for C. sinensis using ELISA, skin test for C. sinensis, radiologic examinations, and interview concerning history of eating raw freshwater fish.


RESULTS
Radiologic evidence of C. sinensis, history of eating raw freshwater fish, and positive serologic result for C. sinensis were found to be related to an increased risk of CC, with the odds ratios (OR)=8.615 (95% confidence interval [CI]=5.045-16.062), OR=2.385 (95% CI=1.527-3.832), and OR=2.272 (95% CI=1.147-4.811), respectively. The risk factors for distal extrahepatic CC were radiologic evidence of C. sinensis (OR=6.571; 95% CI=3.170-15.943) and history of eating raw freshwater fish (OR=2.6; 95% CI=1.294-5.66).


CONCLUSIONS
Radiologic evidence of C. sinensis, history of eating raw freshwater fish and positive serologic result for C. sinensis were significantly associated with CC, including extrahepatic CC.
Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710, South Korea.
Dongil
D
Choi
Jae Hoon
JH
Lim
Kyu Taek
KT
Lee
Jong Kyun
JK
Lee
Seong Ho
SH
Choi
Jin Seok
JS
Heo
Kee-Taek
KT
Jang
Nam Yong
NY
Lee
Seonwoo
S
Kim
Sung-Tae
ST
Hong
D000328:Adult; D000368:Aged; D000818:Animals; D001650:Bile Duct Neoplasms / Q000453:epidemiology*; D001653:Bile Ducts, Intrahepatic / Q000473:pathology*; D016022:Case-Control Studies; D018281:Cholangiocarcinoma / Q000453:epidemiology*; D003003:Clonorchiasis / Q000000981:diagnostic imaging*; D003004:Clonorchis sinensis / Q000302:isolation & purification*; D005260:Female; D006801:Humans; D007723:Korea / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012306:Risk