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. 2009 Jun 2;100(11):1765-70.
doi: 10.1038/sj.bjc.6605063. Epub 2009 May 12.

Viral hepatitis-associated intrahepatic cholangiocarcinoma shares common disease processes with hepatocellular carcinoma

C H Lee  1 , C J Chang, Y J Lin, C N Yeh, M F Chen, S Y Hsieh
Affiliations

Viral hepatitis-associated intrahepatic cholangiocarcinoma shares common disease processes with hepatocellular carcinoma

C H Lee et al. Br J Cancer. .

Abstract

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.

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Figures

Figure 1
Figure 1
Distribution of potential risk factors for ICC among the 160 ICC patients (A) and the 160 control cases (B). B= seropositivity for HBsAg; C= seropositivity for anti-HCV antibody; Cirr= cirrhosis; IHD= intrahepatic duct stone.
Figure 2
Figure 2
Comparison of disease incidence based on age distribution in the 160 ICC patients and 2498 HCC patients. (A) Profiles for viral hepatitis B patients with either HCC or ICC. (B) Profiles for viral hepatitis C patients with either HCC or ICC. Interestingly, the age distribution profiles of patients with viral hepatitis B and C are quite different in both ICC and HCC, whereas the age distribution profiles between ICC and HCC patients with either viral hepatitis B or C are nearly identical.
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