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Cholangiocarcinoma: Demographic Characteristics, Diagnostic Modalities, Therapeutic Options and Risk Factors in an Endemic Area of Human Fascioliasis, Guilan Province North of Iran
Fariborz Mansour-Ghanaei, Javid Rasoulian and Farahnaz Joukar
Background: Although there is no report about association of Cholangiocarcinoma (CCA) and fascioliasis, but the role of other liver flukes has been defined in developing Cholangiocarcinoma. We decided to evaluate the demographic characteristics, diagnostic modalities, therapeutic options and riskfactors of CCA in an endemic area of human fascioliasis.
Materials and Methods: Twenty two patients with CCA and 48 control subjects were enrolled in this study. Controls included twenty four healthy subjects and twenty four in patients with gastrointestinal malignancy and without liver or other systemic disease. All cases and controls were carried out from 2010 to 2011. The medical records and information about liver diseases, family history, past medical history, smoking, and alcohol consumption were collected on both groups. Blood from all participants was tested for HBV and HCV and fasciola markers and then analysed.
Results: Twenty two cholangiocarcinoma cases with a median age of 68 years were included. Twentyone were extrahepatic and only one Intrahepatic CCA. Thirteen (59%) had jaundice and abdominal pain at presentation. Using of CT scan with ERCP or MRCP findings and elevated tumour markers (CA19-9, CEA) were the most diagnostic procedure in patients. The prevalence of smoking and alcohol consumption were not significantly different between cases and controls. Compared with controls, patients had not a higher prevalence of positive HCV Ab (Elisa) and HBs Ag. Anti Fasciola Ab was negative in all cases and controls.
Conclusions: These findings support that there is no positive association between smoking, alcohol consumption and infection with HBV, HCV and Fascioliasis with Cholangiocarcinoma in Guilan province. However, the number of patients was fairly low in our study and this limits our ability to detect actual association between these factors and Cholangiocarcinoma.