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      Cholangiocarcinoma: Present Status and Molecular Aspects of Diagnosis

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          Abstract

          Cholangiocarcinomas are neoplasms that involve the epithelial cells of the bile duct, also known as cholangiocytes. This disease is difficult to diagnose early, as most symptoms present late in the disease. In addition, the specific anatomic position can cause periductal extension and result in a very low radical excision rate and a very poor prognosis. Improved understanding of the features underlying the onset of cholangiocarcinoma and its carcinogenic mechanism may lead to early diagnosis and better prognosis. With the development of molecular biology, much has been learned about oncogenes, tumor-suppressor genes, DNA methylation, microRNAs, and the molecular mechanisms of tumor invasion and metastasis. Based on our research and others, this review article will discuss the current status and prospects of early diagnosis of cholangiocarcinoma.

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          Cholangiocarcinoma.

          Shahid Khan, Howard C Thomas, Brian Davidson … (2005)
          Cholangiocarcinoma is a devastating malignancy that presents late, is notoriously difficult to diagnose, and is associated with a high mortality. The incidence of intrahepatic cholangiocarcinoma is increasing worldwide. The cause for this rise is unclear, although it could be related to an interplay between predisposing genetic factors and environmental triggers. MRI and CT with endoscopic ultrasound and PET provide useful diagnostic information in certain patients. Surgical resection is the only chance for cure, with results depending on careful technique and patient selection. Data suggest that liver transplantation could offer long-term survival in selected patients when combined with neoadjuvant chemoradiotherapy. Chemotherapy and radiotherapy have been ineffective for patients with inoperable tumours. For most of these patients biliary drainage is the mainstay of palliation. However, controversy exists over the type and positioning of biliary stents. Photodynamic treatment is a new palliative technique that might improve quality of life.
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            Increasing incidence and mortality of primary intrahepatic cholangiocarcinoma in the United States.

            T. Patel (2001)
            Clinical observations suggest a recent increase in intrahepatic biliary tract malignancies. Thus, our aim was to determine recent trends in the epidemiology of intrahepatic cholangiocarcinoma in the United States. Reported data from the Surveillance, Epidemiology, and End Results (SEER) program and the United States Vital Statistics databases were analyzed to determine the incidence, mortality, and survival rates of primary intrahepatic cholangiocarcinoma. Between 1973 and 1997, the incidence and mortality rates from intrahepatic cholangiocarcinoma markedly increased, with an estimated annual percent change (EAPC) of 9.11% (95% CI, 7.46 to 10.78) and 9.44% (95%, CI 8.46 to 10.41), respectively. The age-adjusted mortality rate per 100,000 persons for whites increased from 0.14 for the period 1975-1979 to 0.65 for the period 1993-1997, and that for blacks increased from 0.15 to 0.58 over the same period. The increase in mortality was similar across all age groups above age 45. The relative 1- and 2-year survival rates following diagnosis from 1989 to 1996 were 24.5% and 12.8%, respectively. In conclusion, there has been a marked increase in the incidence and mortality from intrahepatic cholangiocarcinoma in the United States in recent years. This tumor continues to be associated with a poor prognosis.
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              Risk factors for cholangiocarcinoma.

              H Serag, Frederick L. Tyson (2011)
              Cholangiocarcinoma (CC) is the second most common primary hepatic malignancy after hepatocellular cancer. CC accounts for approximately 10%-25% of all hepatobiliary malignancies. There are considerable geographic and demographic variations in the incidence of CC. There are several established risk factors for CC, including parasitic infections, primary sclerosing cholangitis, biliary-duct cysts, hepatolithiasis, and toxins. Other less-established potential risk factors include inflammatory bowel disease, hepatitis C virus, hepatitis B virus, cirrhosis, diabetes, obesity, alcohol drinking, tobacco smoking, and host genetic polymorphisms. In studies where the distinction between intra- and extrahepatic CC was used, some potential risk factors seem to have a differential effect on CC, depending on the site. Therefore, the consistent use of a more refined classification would allow a better understanding of risk factors for CC. Copyright © 2011 American Association for the Study of Liver Diseases.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Oncol Res
                Journal ID (iso-abbrev): Oncol Res
                Journal ID (publisher-id): OR
                Title: Oncology Research
                Publisher: Cognizant Communication Corporation (Elmsford, NY )
                ISSN (Print): 0965-0407
                ISSN (Electronic): 1555-3906
                Publication date Collection: 2015
                Publication date (Electronic): 15 September 2015
                Volume: 22
                Issue: 4
                Pages: 177-183
                Affiliations
                [1] Department of Hepatobiliary Surgery, Affiliated Yantai Yuhuangding Hospital, Qingdao University Medical College , Yantai, China
                Author notes
                Address correspondence to Dr. Xiao-Fang Liu, Department of Hepatobiliary Surgery, Affiliated Yantai Yuhuangding Hospital, Qingdao University Medical College, Yantai 264000, China. Tel: +86-535-6691999; Fax: +86-535-6240341; E-mail: Liu634@ 123456263.net
                Article
                Publisher ID: OR814
                DOI: 10.3727/096504015X14343704124386
                PMC ID: 7838449
                PubMed ID: 26351206
                SO-VID: 06c0a7e9-0f8e-4234-b9ca-d07165403af4
                Copyright © Copyright © 2015 Cognizant Comm. Corp.
                License:

                This article is licensed under a Creative Commons Attribution-NonCommercial NoDerivatives 4.0 International License.

                History
                Page count
                Figures: 2, Tables: 1, References: 48, Pages: 7
                Categories
                Subject: Review

                Keywords: cholangiocarcinoma,epidemiology,diagnosis,oncogene,tumor-suppressor gene,methylation,serum tumor markers,micrornas
                Data availability:
                Keywords: cholangiocarcinoma, epidemiology, diagnosis, oncogene, tumor-suppressor gene, methylation, serum tumor markers, micrornas

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