1. Inflammatory Bowel Disease (IBD) is a Risk Factor for Extrahepatic Cholangiocarcinoma (ECC) in Subjects Without Underlying Primary Sclerosing Cholangitis (PSC)
Hassan M. Ghoz1, Esha Baichoo1, Benyam Addissie 1, Lewis R. Roberts1, Roongruedee Chaiteerakij2
1Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
 2Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
Background
Cohort’s Baseline Characteristics
Multivariate Analysis of Potential Risk Factors for pCCA
Summary and Conclusions
Evidence for a discrete role of IBD in the pathogenesis of CCA is scant. It remains unclear whether IBD is an independent risk factor for CCA as the concurrent diagnosis of PSC has not been clearly reported in most studies assessing the effect of IBD on CCA risk. No studies have focused solely on the relationship of ECC to IBD in subjects without PSC.
Variables
pCCA
dCCA
Cases
(n=411)
Controls
(n=808)
(n=103)
(n=204)
Age, years
65.8 ± 12.0
66.0 ± 11.9
67.4 ± 11.1
67.4 ±10.9
Male, n (%)
231 (56.2)
453 (56.1)
65 (63.1)
127 (62.2)
White, n (%)
351 (92.1)
706 (88.3)
93 (95.9)
187 (91.7)
Risk factors, n (%)
Smoking
205 (50.1)
329 (41.2)
65 (63.7)
84 (41.6)
Alcohol
220 (60.9)
628 (78.2)
67 (73.7)
158 (77.5)
Diabetes
67 (16.3)
91 (11.5)
23 (22.3)
26 (12.9)
BMI (>30Kg/m2)
117 (28.7)
196 (25.7)
32 (31.4)
66 (33.3)
Inflammatory Bowel Disease (Combined)
17 (4.14)
14 (1.7)
6 (5.8)
1 (0.5)
Ulcerative Colitis
10 (2.4)
9 (1.1)
4 (3.9)
0 (0)
Crohn’s Disease
7 (1.7)
5 (0.6)
2 (1.9)
Cirrhosis
9 (2.2)
4 (0.5)
HCV
3 (0.4)
2 (1.0)
HBV
3 (0.7)
Incidental Asymptomatic Gallstones
61 (14.8)
19 (2.4)
12 (11.7)
5 (2.5)
Cholecystectomy for Gallstones
109 (20.8)
109 (10.6)
26 (23.2)
28 (12.7)
Choledochal Cyst
1 (1.0)
AOR(95%CI)
P-value
0.3 ( )
<0.0001
1.4 ( )
0.003
4.1 ( )
0.03
4.8 ( )
0.0010
6.3 ( )
7.9 ( )
14.2 ( )
HCV, gallstones, cirrhosis, and smoking were independently associated with increased pCCA risk in non-PSC subjects.
Gallstones and smoking were independent risk factors for dCCA in non-PSC subjects.
There was a significant association between IBD-UC and IBD-CD and pCCA.
There was a significant association between IBD and dCCA.
In summary, IBD was found to be an independent risk factor for ECC in non-PSC subjects.
Variables
Objectives
Determine whether IBD is an independent risk factor for ECC
Identify other risk factors for ECC in non-PSC population
Methods
References
Adjusted Odds Ratio (AOR)
Broome, U., R. Lofberg, et al. (1995). "Primary sclerosing cholangitis and ulcerative colitis: evidence for increased neoplastic potential." Hepatology 22(5):
Schrumpf, E., O. Fausa, et al. (1988). "Hepatobiliary complications of inflammatory bowel disease." Seminars in liver disease 8(3):
Multivariate Analysis of Potential Risk Factors for dCCA
Variables
AOR(95%CI)
P-value
2.2 ( )
0.001
5.4 ( )
0.003
23.5 ( )
<0.0001
Acknowledgments
Adjusted Odds Ratio (AOR)
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