Abstract
Patients with inflammatory bowel disease (IBD) have an increased risk of extra-intestinal cancer, whereas its impact on cholangiocarcinoma (CC) remains unknown. The aim of this study was to obtain a reliable estimate of the risk of CC in IBD patients through a meta-analysis of clinical observational studies. Relevant studies were retrieved by searching PUBMED, EMBASE and Web of Science Databases up to Dec 2013. Four population-based case-control and two cohort studies with IBD were identified. Summary relative risk (RR) and its corresponding 95% confidence interval (CI) were calculated using a random-effects model. Potential sources of heterogeneity were detected using subgroup analyses. The pooled risk estimate indicated IBD patients were at increased risk of CC (RR = 2.63, 95%CI = 1.47-4.72). Moreover, the increased risk of CC was also associated with Crohn's disease (RR = 2.69, 95%CI = 1.59-4.55) and ulcerative colitis (RR = 3.40, 95%CI = 2.50-4.62). In addition, site-specific analyses revealed that IBD patients had an increased risk of intrahepatic CC (ICC) (RR = 2.61, 95%CI = 1.72-3.95) and extrahepatic CC (ECC) (RR = 1.47, 95%CI = 1.10- 1.97). This study suggests the risk of CC is significantly increased among IBD patients, especially in ICC cases. Further studies are warranted to enable definite conclusions to be drawn.
Highlights
Cholangiocarcinoma (CC), a malignant tumor arising from the epithelial cells lining the biliary tree, is characterized by a diagnostically and therapeutically challenging cancer (Patel, 2011)
Results from our analyses confirmed that inflammatory bowel disease (IBD) patients were at risk of CC, especially a 2.61-fold increased risk of intrahepatic CC (ICC)
We further found that both Crohn’s Disease (CD) and ulcerative colitis (UC) were associated with an increased risk of CC, respectively
Summary
Cholangiocarcinoma (CC), a malignant tumor arising from the epithelial cells (cholangiocytes) lining the biliary tree, is characterized by a diagnostically and therapeutically challenging cancer (Patel, 2011). It is the second most common primary hepatic malignancy after hepatocellular cancer, contributing to approximately 10–25% of all hepatobiliary malignancies (Blechacz et al, 2008; Sripa et al, 2008; Gatto et al, 2010). The clinical distinction between ICC and ECC has become significantly crucial due to their possibly different epidemiological characteristics (Patel., 2006; Gatto et al, 2010)
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