title: [Risk factors of hepatolithasis-associated intrahepatic cholangiocarcinoma and the value of serum tumor-related makers in its diagnosis].
abstract: OBJECTIVE
  To explore the risk factors of hepatolithasis-associated intrahepatic cholangiocarcinoma (HICC) and the clinical value of serum tumor-related markers for the detection of HICC.
  
  
  METHODS
  Clinical data were collected from 58 patients pathologically diagnosed as HICC between 2005 and 2011 in West China Hospital of Sichuan University and 189 patients diagnosed as hepatolithiasis alone in the same period as matched control group. Logistic regression analysis was used to detect the independent risk factors of HICC and ROCs curve were constructed to assess the diagnostic value of CA199, CEA, GGT and ALP.
  
  
  RESULTS
  The patients in both HICC group and control group presented similar clinical symptoms except weight loss. The results of univariate analysis suggested cholangioenterostomy (P < 0.001), early stone removal (OR = 0.001), family history of cancer (P = 0.001) were associated with the incidence of HICC. The results of Multivariate analysis suggested diabetes mellitus (OR = 3.621, 95% CI: 1.333-9.834, P = 0.012), family history of cancer (OR = 16.830, 95% CI: 1.937-146.21, P = 0.010), cholangioenterostomy (OR = 5.115, 95% CI: 1.733-15.098, P = 0.003), early removal of stone (OR = 0.315, 95% CI: 0.128-0.771, P = 0.011) and CA199 > 100 IU/mL (OR = 5.478, 95% CI: 2.539-11.820, P < 0.001) were independent risk factors for hICC. Serum CA199 and CEA level presented low diagnostic accuracy, a combined test (CA199 > 100 IU/mL or CEA > 5 ng/mL) showed better diagnostic performance with a 71.05% of sensitivity and 82.05% of specificity.
  
  
  CONCLUSIONS
  Cholangioenterostomy, diabetes, early and complete stone removal were independent risk factors for hepatolithiasis-associated ICC. A combined test of CA199 and CEA could be an effective detecting tool for HICC.
authors.forename: Chen
authors.initials: C
authors.lastname: Yang
authors.forename: Jie
authors.initials: J
authors.lastname: Zhang
authors.forename: Yi-Xin
authors.initials: YX
authors.lastname: Lin
authors.forename: Rong-Xing
authors.initials: RX
authors.lastname: Zhou
authors.forename: Xian-Ze
authors.initials: XZ
authors.lastname: Xiong
authors.forename: Nan-Shen
authors.initials: NS
authors.lastname: Cheng
mesh_terms: D001650:Bile Duct Neoplasms / Q000097:blood / Q000175:diagnosis*; D001653:Bile Ducts, Intrahepatic; D014408:Biomarkers, Tumor / Q000097:blood*; D002681:China; D018281:Cholangiocarcinoma / Q000097:blood / Q000175:diagnosis*; D006801:Humans; D012307:Risk Factors; D012680:Sensitivity and Specificity
chemical_list: D014408:Biomarkers, Tumor