Abstract
Introduction
Cholangiocarcinoma (CCA) is an epithelial cancer originating from the bile ducts with features of cholangiocyte differentiation. The global incidence of this rare disease is on the rise, and it is the second most common primary hepatobiliary malignancy. We reviewed risk factors for cholangiocarcinoma development and also described potential screening strategies for this malignancy. We also report two cases in which CCA developed in patients without previously determined risk factors known for CCA.
Discussion
The first case is a patient with longstanding secondary sclerosing cholangitis (SSC), and the second is a patient with autoimmune hepatitis (AIH). These two cases may indicate a possible association between SSC and AIH with CCA, thus, expanding the spectrum of risk factors of CCA.
Similar content being viewed by others
References
de Groen PC, Gores GJ, LaRusso NF, Gunderson LL, Nagorney DM. Biliary tract cancers. N Engl J Med 1999;341:1368–78. doi:10.1056/NEJM199910283411807.
Shaib YH, Davila JA, McGlynn K, El-Serag HB. Rising incidence of intrahepatic cholangiocarcinoma in the United States: a true increase? J Hepatol 2004;40:472–7. doi:10.1016/j.jhep.2003.11.030.
Mouzas IA, Dimoulios P, Vlachonikolis IG, Skordilis P, Zoras O, Kouroumalis E. Increasing incidence of cholangiocarcinoma in Crete 1992-2000. Anticancer Res 2002;22:3637–41.
Khan SA, Davidson BR, Goldin R, Pereira SP, Rosenberg WM, Taylor-Robinson SD, et al. Guidelines for the diagnosis and treatment of cholangiocarcinoma: consensus document. Gut 2002;51(Suppl. 6):VI1–VI9. doi:10.1136/gut.51.suppl_6.vi1.
Boris B, Gregory JG. Cholangiocarcinoma: advances in pathogenesis, diagnosis, and treatment. Hepatology 2008;48(1):308–21. doi:10.1002/hep.22310.
Welzel TM, McGlynn KA, Hsing AW, O’Brien TR, Pfeiffer RM. Impact of classification of hilar cholangiocarcinomas (Klatskin tumors) on the incidence of intra-and extrahepatic cholangiocarcinoma in the United States. J Natl Cancer Inst 2006;98:873–5.
Burak K, Angulo P, Pasha TM, Egan K, Petz J, Lindor KD. Incidence and risk factors for cholangiocarcinoma in primary sclerosing cholangitis. Am J Gastroenterol 2004;99:523–6. doi:10.1111/j.1572-0241.2004.04067.x.
Jimeno A, Rubio-Viqueira B, Amador ML, Oppenheimer D, Bouraoud N, Kulesza P, et al. Epidermal growth factor receptor dynamics influences response to epidermal growth factor receptor targeted agents. Cancer Res 2005;65:3003–10.
Wiedmann M, Feisthammel J, Bluthner T, Tannapfel A, Kamenz T, Kluge A, et al. Novel targeted approaches to treating biliary tract cancer: the dual epidermal growth factor receptor and ErbB-2 tyrosine kinase inhibitor NVP-AEE788 is more efficient than the epidermal growth factor receptor inhibitors gefitinib and erlotinib. Anticancer Drugs 2006;17:783–95. doi:10.1097/01.cad.0000217433.48870.37.
Zhang Z, Lai GH, Sirica AE. Celecoxib-induced apoptosis in rat cholangiocarcinoma cells mediated by Akt inactivation and Bax translocation. Hepatology 2004;39:1028–37. doi:10.1002/hep.20143.
Wu T, Leng J, Han C, Demetris AJ. The cyclooxygenase-2 inhibitor celecoxib blocks phosphorylation of Akt and induces apoptosis in human cholangiocarcinoma cells. Mol Cancer Ther 2004;3:299–307.
Date K, Matsumoto K, Kuba K, Shimura H, Tanaka M, Nakamura T. Inhibition of tumor growth and invasion by a four-kringle antagonist (HGF/NK4) for hepatocyte growth factor. Oncogene 1998;17:3045–54. doi:10.1038/sj.onc.1202231.
Sirica AE, Lai GH, Endo K, Zhang Z, Yoon BI. Cyclooxygenase-2 and ERBB-2 in cholangiocarcinoma: potential therapeutic targets. Semin Liver Dis 2002;22:303–13. doi:10.1055/s-2002-34507.
Olnes MJ, Erlich R. A review and update on cholangiocarcinoma. Oncology 2004;66:167–79. doi:10.1159/000077991.
LaRusso NF, Shneider BL, Black D, Gores GJ, James SP, Doo E, et al. Primary sclerosing cholangitis: summary of a workshop. Hepatology 2006;44:746–64. doi:10.1002/hep.21337.
Gossard AA, Angulo P, Lindor KD. Secondary sclerosing cholangitis: a comparison to primary sclerosing cholangitis. Am J Gastroenterol 2005;100:1330–33. doi:10.1111/j.1572-0241.2005.41526.x.
Edward L. Krawitt, Autoimmune Hepatitis. New Engl J Med 2006;354:54–66. doi:10.1056/NEJMra050408.
Charatcharoenwitthaya P, Enders FB, Halling KC, Lindor KD. Utility of serum tumor markers, imaging, and biliary cytology for detecting cholangiocarcinoma in primary sclerosing cholangitis. Hepatology 2008;48(4):1106–117. doi:10.1002/hep.22441.
Chen CY, Shiesh SC, Tsao HC, Lin XZ. The assessment of biliary CA 125, CA 19-9 and CEA in diagnosing cholangiocarcinoma- the influence of sampling time and hepatolithiasis. Hepatogastroenterology 2002;49:616–20.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Elfaki, D.H., Gossard, A.A. & Lindor, K.D. Cholangiocarcinoma: Expanding the Spectrum of Risk Factors. J Gastrointest Canc 39, 114–117 (2008). https://doi.org/10.1007/s12029-008-9040-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12029-008-9040-0