Interactive role of diabetes mellitus and female sex in the risk of cholangiocarcinoma: A population-based nested case-control study.

Yan-Jiun Huang,Li-Nien Chien,Tzu-Ching Meng,Ming-Tsang Chuang,Yun Yen,Alexander Th Wu,Hung-Yi Chiou

doi:10.18632/oncotarget.14254

Abstract

Diabetes mellitus (DM) has been associated with an increased risk of extrahepatic cholangiocarcinoma (ECC) and intrahepatic cholangiocarcinoma (ICC). However, the role of DM in a population with a lower incidence of ECC remains unclear. We investigated the role of DM and other risk factors for ECC and ICC by conducting a population-based, nested, case–control study in Taiwan, a region with a lower incidence but a higher proportion of ICC. We identified patients who received a diagnosis of cholangiocarcinoma (CC) from the Taiwan Cancer Registry between 2003 and 2009. A total of 6,093 CC cases (ICC: 4,695; ECC: 1,396) and 60,906 matched controls were included. Compared with the controls, the patients with ICC and ECC were more likely to have DM, with an adjusted OR of 1.22 [95% confidence interval (CI): 1.07–1.39] and 1.48 (95% CI: 1.18–1.85), respectively. DM was associated with an increased risk of CC in the women and patients without a history of biliary tract diseases. Moreover, compared with the controls, DM was not associated with an increased risk of ECC in the patients who received cholecystectomy. These findings strongly support the positive association between DM and the increased risk of both ICC and ECC; however, this association was not observed in the patients who received cholecystectomy.

Highlights

Cholangiocarcinoma (CC) is primarily a cancer of the epithelial cells in the bile ducts arising anywhere along the intrahepatic or extrahepatic biliary tree [1, 2]
The risk of Diabetes mellitus (DM) was more positively associated with intrahepatic cholangiocarcinoma (ICC) and extrahepatic cholangiocarcinoma (ECC) in the patients without biliary tract diseases
DM was not found to be associated with the risk of ECC in the patients who received cholecystectomy

Summary

Introduction

Cholangiocarcinoma (CC) is primarily a cancer of the epithelial cells (mostly adenocarcinoma) in the bile ducts arising anywhere along the intrahepatic or extrahepatic biliary tree [1, 2]. Numerous biliary tract diseases have been identified as risk factors for CC, including primary sclerosing cholangitis, liver flukes (Opisthorchis viverrini and Clonorchis sinensis) found in endemic regions such as Thailand, www.impactjournals.com/oncotarget cholelithiasis, hepatolithiasis [3,4,5], and congenital biliary tract abnormalities such as choledochal cysts [3, 6, 7, 9]. Among these risk factors, pancreaticobiliary maljunction, cholelithiasis, and cholecystectomy have been associated with ECC [5]. Its role in Asian countries remains controversial because of heterogeneity in the study design, selected study population, and study regions [11,12,13,14,15,16]

Methods

Results

Conclusion