Medical history and the risk of biliary tract cancers in Shanghai, China: implications for a role of inflammation

Abstract

Several lines of evidence suggest that inflammation may play a role in the etiology of biliary tract cancers. To examine further the role of inflammation, we evaluated the associations between self-reported inflammatory-related medical conditions and the risk of biliary tract cancers in a population-based case-control study in Shanghai, China. Our analysis included 368 gallbladder cancer cases, 191 bile duct cancer cases, 68 ampulla of Vater cancer cases, and 959 healthy subjects. We used logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for biliary tract cancers in relation to six inflammation-related conditions. Gallbladder cancer was significantly associated with cholecystitis occurring at least 5 years prior to interview (OR = 1.7, 95% CI 1.1-2.9). Even though biliary stones did not significantly modify the associations between cholecystitis and gallbladder cancer, 90% of the gallbladder cancer cases with cholecystitis also had biliary stones, indicating that stones likely play an important role in the link between cholecystitis and gallbladder cancer. Among subjects who smoked and drank alcohol, a history of gastric (OR = 4.3, 95% CI 1.2-15.0) or duodenal ulcers (OR = 3.7, 1.2-12.0) was associated with an excess risk of gallbladder cancer. Although the mechanisms are unclear, our results further support the role for inflammation in the etiology of biliary tract cancers.

Association between Helicobacter pylori infection and gallbladder diseases: A retrospective study

“…Helicobacter pylori ( H. pylori ) infection is very common throughout the world but is particularly highly prevalent in developing countries, and the prevalence is decreasing in the developed countries . This infection is more common in elderly people than in adolescents …”

Association of inflammatory and other immune markers with gallbladder cancer: Results from two independent case-control studies

“…Other proposed risk factors also likely act through inflammatory pathways. For example, infections (e.g., Helicobacter species), obesity, diabetes, metabolic syndrome, and other inflammation-related conditions have been associated with increased risk of GBC [6–11], while aspirin use has been associated with decreased risk [1, 12]. In addition, single nucleotide polymorphisms in inflammatory-related genes have been associated with GBC [13–15].…”

A Comparative Study of Clinicopathological Features between Chronic Cholecystitis Patients with and without Helicobacter pylori Infection in Gallbladder Mucosa

“…In China, more than 90% of the cholecystitis cases are claimed to be caused by symptomatic cholelithiasis, the incidence of which is approximately 10% of the adult population. [1], [2] Histologically, chronic cholecystitis presents a large range of related inflammatory epithelial changes including mononuclear infiltrate, fibrosis, thickness of muscular layer, dysplasia, hyperplasia and metaplasia-the last three have been considered as premalignant lesions. [3]–[5].…”