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Review
. 2024 Nov 7;32(3):151-160.
doi: 10.1159/000541868. eCollection 2025 Jun.

Occupational and Environmental Cholangiocarcinoma-Related Toxic Exposures

Tianyu She  1 , Nairuti Shah  1 , Benna Jacob  1 , Nathan Starkman  2 , Julie Lieman  1 , Amandeep Kaur  1 , Neal Shah  3 , Marc Wilkenfeld  4
Affiliations
Review

Occupational and Environmental Cholangiocarcinoma-Related Toxic Exposures

Tianyu She et al. GE Port J Gastroenterol. .

Abstract
in English, Portuguese

Cholangiocarcinoma (CCA) is a malignancy that originates from the epithelial cells of the biliary system. Despite advancements in medical diagnostic techniques, CCAs remain a challenge to detect due to their silent clinical progression, making it difficult to diagnose these diseases. There are several well-established risk factors for CCA, including biliary tract infection and inflammation. However, there is also growing evidence that community and occupational exposures play a significant role in the development of bile duct cancers. This review examines the geographical distribution of these risk factors and the importance of surveillance in individuals exposed to these toxins who are more prone to developing CCA.

O colangiocarcinoma (CCA) é uma neoplasia maligna cuja origem reside nas células epiteliais do sistema biliar. Não obstante os progressos registados nos métodos de diagnóstico, a deteção dos CCA é um desafio, em virtude da sua progressão clínica silenciosa, tornando difícil o diagnostico desta entidade. Há diversos fatores de risco estabelecidos para o CCA, incluindo infeção e inflamação do trato biliar. Todavia, há também cada vez mais evidência de que as situações de exposição comunitária e profissional têm um papel significativo no desenvolvimento dos cancros das vias biliares. Esta análise aborda a distribuição geográfica destes fatores de risco e a importância da monitorização em indivíduos expostos a estas toxinas, os quais são mais propensos a desenvolver cancro das vias biliares.

Keywords: Cholangiocarcinoma; Extrahepatic cholangiocarcinoma; Intrahepatic cholangiocarcinoma; Occupational exposures; Toxic exposures.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1.
Fig. 1.
Cholangiocarcinoma can be diagnosed by a number of different mechanisms. Radiologic imaging allows for the visualization of mass. Endoscopic evaluation allows for visualization and sampling of the mass as well as therapeutic stent placement. Cytology allows for more specific tissue analysis.
Fig. 2.
Fig. 2.
Various pathways of 1,2-dichloropropane exposure. Mutagenic effects such as increased DNA breakage and transitional mutations from CG to TA; induction of inflammatory NFKB and TNF-alpha pathways, leading to DNA editing enzyme activation.
Fig. 3.
Fig. 3.
Trapped asbestos fibers within smaller bile ducts, particularly at the level of the canals of Hering, where they may exert carcinogenic effects, inducing HpSC malignant transformation and eventually ICC development. Reproduced with permission, MDPI, Basel, Switzerland (https://creativecommons.org/licenses/by/4.0), Brandi G, Tavolari S. Asbestos and intrahepatic cholangiocarcinoma. Cells 2020;9.
See this image and copyright information in PMC

References

    1. Blechacz B, Komuta M, Roskams T, Gores GJ. Clinical diagnosis and staging of cholangiocarcinoma. Nat Rev Gastroenterol Hepatol. 2011;8(9):512–22. - PMC - PubMed
    1. DeOliveira ML, Cunningham SC, Cameron JL, Kamangar F, Winter JM, Lillemoe KD, et al. . Cholangiocarcinoma: thirty-one-year experience with 564 patients at a single institution. Ann Surg. 2007;245(5):755–62. - PMC - PubMed
    1. Tyson GL, El-Serag HB. Risk factors for cholangiocarcinoma. Hepatology. 2011;54(1):173–84. - PMC - PubMed
    1. Welzel TM, Graubard BI, El-Serag HB, Shaib YH, Hsing AW, Davila JA, et al. . Risk factors for intrahepatic and extrahepatic cholangiocarcinoma in the United States: a population-based case-control study. Clin Gastroenterol Hepatol. 2007;5(10):1221–8. - PMC - PubMed
    1. Mimaki S, Totsuka Y, Suzuki Y, Nakai C, Goto M, Kojima M, et al. . Hypermutation and unique mutational signatures of occupational cholangiocarcinoma in printing workers exposed to haloalkanes. Carcinogenesis. 2016;37(8):817–26. - PMC - PubMed

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