Evaluation of Risk Factors and Clinicopathologic Features for Intrahepatic Cholangiocarcinoma in Southern China: A Possible Role of Hepatitis B Virus

Abstract

The independent association of HBV infection with ICC, synergy between cirrhosis and HBV infection, and some clinicopathological similarities between HBV-related ICC and hepatocellular carcinoma suggests that both may share similar or common tumorigenic process and may possibly originate from malignant transformation of hepatic progenitor cell.

Comparison of clinicopathological characteristics between cirrhotic and non-cirrhotic patients with intrahepatic cholangiocarcinoma: A large-scale retrospective study

“…The findings of this study suggested that ICC associated with cirrhosis may display a biological behavior similar to that of HCC and, thus, have a better prognosis. Although the etiology of ICC remains unclear, there is growing evidence suggesting that ICC associated with cirrhosis may be derived from the same hepatic progenitor cells as HCC (13,14,18,19) and, thus, behaves more like HCC, which is generally considered to have a more favorable prognosis compared with ICC (2,5,27,29). The observations of the present study indicate that ICC occurring in patients with cirrhosis may share a common carcinogenic process with HCC.…”

“…HBV infection and cirrhosis are established risk factors for HCC (8,11), and several recent studies have suggested HBV infection may also be associated with the occurrence of ICC (12,13,18,19); however, the association between cirrhosis and the pathogenesis/prognosis of ICC remains unknown. The present study confirmed the earlier observation that cirrhosis is prevalent among patients with ICC in highly endemic areas (6), as it was observed in 23.0% of our patients, which is a markedly higher percentage compared with Western (26), and 90.1% of cases with cirrhosis in the present series were seropositive for hepatitis B surface antigen, indicating HBV-related cirrhosis.…”

“…There are several known factors affecting the prognosis of ICC after surgery, including surgical margin status, multiple tumors, LN metastasis and vascular invasion (2,6,7,25,28). In earlier studies on ICC, cirrhosis (21), unlike HBV infection (13,18,19), was shown to be an independent unfavorable prognostic factor for survival, but little is known on the underlying mechanism. However, the multivariate analysis in this series and our former study (20) revealed that cirrhosis was an independent favorable prognostic factor for survival of ICC patients following surgery.…”

“…A significant proportion of ICC patients are also cirrhotic; however, the prognostic role of this finding has not been extensively investigated. Although HBV infection has been reported to be a favorable prognostic factor for ICC patients and the clinicopathological characteristics differ between patients with and those without HBV infection (13,18,19), the role of cirrhosis in the prognosis of ICC patients has not been fully elucidated due to the limited number of related studies. Cirrhosis has been found to be a favorable prognostic factor for ICC patients in our former study (20); however, the opposite result was reported by another previous study (21).…”

Glasgow Prognostic Score predicts prognosis of intrahepatic cholangiocarcinoma

“…However, ICC patients carrying HBV had a better prognosis compared with those without HBV infection (64,65). This is likely due to a lower tendency for metastasis towards the perihepatic lymph nodes and a higher rate of encapsulation in ICC patients with HBV (66,67). In addition, the immunological memory caused by a previous HBV infection may be quickly activated by the HBV-relevant ICC, promoting antitumour immunity (68,69).…”