Associations between ultrasound screening findings and cholangiocarcinoma diagnosis in an at-risk population

Abstract

The rate of cholangiocarcinoma (CCA) is increasing every year, especially in northeastern Thailand. Screening for CCA using ultrasonography (US) is the fastest technique to identify patients in early stage of CCA development. Currently, few studies have examined patterns of hepatobiliary abnormalities identified using US, which can be indicative of CCA. We aim to evaluate the rate of CCA and its relations to history of US findings. Our study included participants who underwent US and pathological diagnosis of CCA from the Cholangiocarcinoma Screening and Care Program, Northeast Thailand between 2013 and 2020. Data on histological findings were based on the standard protocol of the tertiary hospital at Khon Kaen University. CCA data is categorized into two groups (yes/no) to find the relationship with history of US findings. The adjusted odds ratio (AOR) and their 95% confidence intervals (CI) were used to evaluate the relationship obtained by multiple logistic regression. Of 1880 subjects who underwent US and a pathological diagnosis of CCA, the overall rate of CCA was 35.74%. CCA rate among those with liver mass (LM) was 54.85% and with dilated bile duct (DBD) was 62.01%. The relationship between DBD and CCA was highly significant (AOR = 3.46; 95% CI 2.74–4.36) followed by LM (AOR = 2.28; 95% CI 1.81–2.86) P value < 0.001. Our study reveals that US findings history have a strong association with CCA, especially in people diagnosed with DBD and LM. Therefore, these abnormalities can be indicators for suspected CCA diagnosis through US.

Spatial analysis of cholangiocarcinoma in relation to diabetes mellitus and Opisthorchis viverrini infection in Northeast Thailand

“…These observed effects remained significant even after adjusting for the influence of gender and age, both identified as significant covariates in this investigation. This discovery aligns with prior research indicating that gender and age factors are linked to CCA, particularly among males and the elderly 18 , 26 , 30 , 31 .…”

“…Understanding the spatial distribution of CCA cases in relation to DM and O. viverrini infection is paramount for crafting targeted prevention and control strategies. Moreover, this knowledge is crucial for enhancing early detection and treatment outcomes, particularly in high-risk areas such as Northeast Thailand 18 , 26 . This region is endemic for O. viverrini , the primary cause of abnormalities in the biliary system examined in this study and a key factor on the etiological pathway leading to the development of CCA 27 .…”

Association of Cholangiocarcinoma among People with Periductal Fibrosis

“…The high incidence levels in Thailand may be explained by highly prevalent Opisthorchis viverrini infection, which has been associated with increased risk of CCA (Sripa et al, 2011;Tyson and El-Serag, 2011;Thinkhamrop et al, 2021). Other factors such as hepatitis B, hepatitis C, liver disease, and bile duct diseases such as periductal fibrosis (PDF) also pose potential risk for CCA (Tyson and El-Serag, 2011;Khan et al, 2019;Clements et al, 2020;Thinkhamrop et al, 2022) (Chamadol et al, 2014).…”

Improvement of Survival Outcomes of Cholangiocarcinoma by Ultrasonography Surveillance: Multicenter Retrospective Cohorts

“…Therefore, a 5-YSR for patients with dCCA (38.8%) was significantly better than iCCA (21.1%) and pCCA (18.3%) as presented in walk in groups (Table 2). US screening has been reported as a tool for the early detection of premalignant lesions and early stage of CCA [15][16][17][18][19][20][21]. The suspected CCA cases without symptoms from preliminary detection were diagnosed as all types of CCA, especially iCCA and pCCA for which there are no symptoms until advanced stage, resulting in early treatment, surveillance, and improvement of overall survival.…”

“…US also offers several advantages, due to its accessibility, speed, ease of performance, portability and low cost [14]. Therefore, US should be considered as the firstchoice imaging modality for screening abnormalities associated with CCA in Thailand [15][16][17][18][19]. Ultrasound screening was systematically applied in the Cholangiocarcinoma Screening and Care Program (CASCAP), to determine the utility of the application for early diagnosis of CCA combined with prevention, treatment, and follow-up.…”