Cholelithiasis and the risk of intrahepatic cholangiocarcinoma: a meta-analysis of observational studies. Issue 1 (December 2015)

• Record Type: Journal Article
• Authors: Cai, Hao; Kong, Wen-Tao; Chen, Chao-Bo; Shi, Guo-Ming; Huang, Cheng; Shen, Ying-Hao; Sun, Hui-Chuan
• Is Part Of: BMC cancer. Volume 15:Issue 1(2015)
• Page Start: 1
• Page End: 7
• Publication Date: 2015-12
• Subjects: Intrahepatic cholangiocarcinoma -- Cholelithiasis -- Choledocholithiasis -- Cholecystolithiasis -- Risk factors -- Meta-analysis; Cancer -- Periodicals; 616.994005
• DOI: 10.1186/s12885-015-1870-0
• Languages: English
• ISSNs: 1471-2407

Abstract

Abstract Background The etiological factor for intrahepatic cholangiocarcinoma (ICC) is not clear. Although it has been widely accepted that intrahepatic biliary tree stone is associated with increased risk of ICC, the role of extrahepatic biliary tree stone in the incidence of ICC is controversial. In the present study we aim to evaluate the association between pre-existing choledocholithiasis and cholecystolithiasis and the risk of ICC. Methods PubMed, Embase, and Web of Science were searched to identify cohort and case–control studies on the association between choledocholithiasis or cholecystolithiasis and the risk of ICC. Studies that met the inclusion criteria were subjected to a meta-analysis performed with Stata statistical software. Either a fixed or random effect model was used, depending on the heterogeneity within the studies. Egger's test was performed to assess publication bias. Results Seven case–control studies met our inclusion criteria. Of the 123, 771 participants, 4763 (3.85 %) were patients with ICC, and 119, 008 were tumor-free controls. The presence of pre-existing bile duct stones (choledocholithiasis alone or choledocholithiasis accompanied by hepatolithiasis) was associated with the risk of ICC (odds ratio [OR] 17.64, 95 % confidence interval [CI] 11.14–27.95). Even the presence of choledocholithiasis alone (in the absence of hepatolithiasis) was associated with a high risk of ICC (OR 11.79, 95 % CI 4.17–33.35). Cholecystolithiasis may possibly contributed to the incidence of ICC (OR 2.00, 95 % CI 1.16–3.42), with large heterogeneity within studies (I 2 = 78.5 %). Conclusions Bile duct stones including choledocholithiasis are important risk factors for ICC. Careful surveillance of patients with extrahepatic biliary tree stone should be considered.