Comparison of Clinical Characteristics between Occupational and Sporadic Young-Onset Cholangiocarcinoma

Rena Kaneko,Shoji Kubo,Yuzuru Sato

doi:10.7314/apjcp.2015.16.16.7195

Abstract

Since seventeen employees of an offset printing company in Osaka, Japan developed cholangiocarcinoma it has become recognized as an occupational cancer. This study investigated the differences of clinical features between occupational cholangiocarcinoma and sporadic young-onset cholangiocarcinoma. Thirty-four young adults (<50 years old) with sporadic cholangiocarcinoma were extracted from the Rosai Hospital Group database (sporadic group) and their clinical features were compared with those of 17 patients with occupational cholangiocarcinoma (occupational group). The 34 patients in the sporadic group were treated for cholangiocarcinoma at 16 different Rosai hospitals. There were significant differences of age (p<0.01), gender (p<0.01), abnormal laboratory tests (p<0.01), and tumor location (p<0.01) between the two groups. The percentage of patients with abnormal laboratory tests was significantly higher in the occupational group than in the sporadic group (p<0.001). Regional dilation of bile ducts, which is a characteristic of occupational cholangiocarcinoma, was not observed in the sporadic group. No cluster of cholangiocarcinoma cases was identified in the Rosai Hospital database. There were differences of clinical features between occupational and sporadic cholangiocarcinoma, which might be helpful for diagnosing occupational cholangiocarcinoma in the future.

Highlights

A cluster of cholangiocarcinoma cases was reported among relatively young workers in the offset color proof printing department of a printing company in Osaka, Japan (Kumagai et al, 2013; Kubo et al, 2014)
It was reported that the cluster of cholangiocarcinoma cases detected in Osaka may not be reproduced in the printing industry nationwide from analysis of the Japan Health Insurance Association claims database (Okamoto et al, 2013)
This study identified some differences of clinical features between occupational and sporadic cholangiocarcinoma

Summary

Introduction

The patients with occupational cholangiocarcinoma at the printing company were typically relatively young male workers with high serum levels of γ -glutamyl transpeptidase (γ -GTP) and regional dilatation of the intrahepatic bile ducts without obstruction by the tumor. In these patients, the primary cancer arose from a large bile duct (common hepatic duct, left or right hepatic ducts, or the first to third branches of the intrahepatic bile ducts) and they had co-existing precancerous lesions such as biliary intraepithelial neoplasia (BilIN) and intraductal neoplasms of the bile ducts (Kubo et al, 2014). The present study was performed to investigate the differences of clinical features between patients who developed occupational cholangiocarcinoma at the printing company in Osaka and young-onset patients with sporadic cholangiocarcinoma treated at the Rosai hospitals nationwide

Materials and Methods

Findings

Discussion