Viral hepatitis-associated intrahepatic cholangiocarcinoma shares common disease processes with hepatocellular carcinoma.
Bile duct cells and hepatocytes differentiate from the same hepatic progenitor cells. To investigate the possible association of viral hepatitis B and C with intrahepatic cholangiocarcinoma (ICC), we conducted a retrospective case-control study using univariate and multivariate logistic analyses to identify risk factors for ICC. Besides hepatic lithiasis (25.6%; P<0.001), seropositivity for hepatitis B surface antigen (37.5% of all ICC patients; odds ratio (OR) =4.985, P<0.001) and seropositivity for hepatitis C antibodies (13.1%; OR=2.709; P=0.021) are the primary independent risk factors for ICC. Cirrhosis exerted synergic effects on the development of ICC. We compared the age distributions of viral-hepatitis associated ICC to that of viral hepatitis-associated hepatocellular carcinoma (HCC). The mean age of ICC patients with viral hepatitis B (56.4+/-11.1 years) were 9 years younger than that of ICC patients with viral hepatitis C (65.6+/-9.17 years), similar to that observed in HCC. The incidence ratio of HCC : ICC : CHC (combined hepatocellular cholangiocarcinoma) in our population was 233 : 17 : 1 consistent with the theoretic ratio of hepatocyte number to cholangiocyte number in the liver. Our findings indicated that both viral hepatitis-associated ICC and HCC shared common disease process for carcinogenesis and, possibly, both arose from the hepatic progenitor cells.
Lee
C H
CH
Division of General and Geriatric Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Chang
C J
CJ
Lin
Y J
YJ
Yeh
C N
CN
Chen
M F
MF
Hsieh
S Y
SY
D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000209:etiology* / Q000821:virology; D018281:Cholangiocarcinoma / Q000209:etiology* / Q000821:virology; D005260:Female; D006509:Hepatitis B / Q000150:complications* / Q000821:virology; D006526:Hepatitis C / Q000150:complications* / Q000821:virology; D006801:Humans; D008103:Liver Cirrhosis / Q000209:etiology / Q000821:virology; D008113:Liver Neoplasms / Q000209:etiology* / Q000821:virology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors