Intrahepatic cholangiocarcinoma (ICC) is a malignant tumor that originates in the epithelial cells of the secondary bile ducts and their branches in the liver. It is second only to hepatocellular carcinoma in the incidence of primary liver cancer.
The only radical treatment for intrahepatic cholangiocarcinoma is surgery, but because of its insidious onset and lack of obvious symptoms in the early stage, most patients are in the middle to late stage when they are diagnosed, resulting in loss of surgical opportunity.
So what are the risk factors for intrahepatic cholangiocarcinoma? What is the specific pathogenesis? Let’s take a look.
Viral hepatitis-associated cirrhosis
In recent years, several studies at home and abroad have shown that hepatitis B or C-related cirrhosis is not only a major risk factor for hepatocellular carcinoma, but also for intrahepatic cholangiocarcinoma, with patients with hepatitis C cirrhosis having a risk of intrahepatic cholangiocarcinoma of up to 3.5% within 10 years.
Continued chronic infection with the hepatitis virus leads to a prolonged inflammatory state of liver tissue that destroys bile duct epithelial cells and surrounding tissue, which may contribute to intrahepatic cholangiocarcinoma.
Intrahepatic bile duct stones
China is a country with a high prevalence of intrahepatic bile duct stones, and the incidence of intrahepatic bile duct stones complicated by bile duct cancer is 2% to 10%.
Bacterial infection, biliary stasis, and mechanical irritation caused by stones can lead to abnormal proliferation of mucosal glandular epithelium and even malignant transformation.
Hepatic schistosomiasis
There is a close association between Mus musculus post-testis and Schistosoma chinensis and intrahepatic bile duct cancer, with Schistosoma chinensis being geographically endemic in China.
The mechanism of hepatic schistosome carcinogenesis may lie in the mechanical irritation of adult worms peristaltic in the bile ducts and the chemical irritation caused by the metabolites and bile components of the worms.
Other
Alcoholic cirrhosis, as well as cirrhosis of other causes, is also an important risk factor for intrahepatic bile duct cancer.
In addition, foreign studies have shown that biliary cirrhosis, congenital dilated intrahepatic bile ducts (Caroli disease), diabetes, and obesity are also strongly associated with the development of intrahepatic bile duct cancer.
Summary
People with the above risk factors should be alert for the development of intrahepatic cholangiocarcinoma if they develop symptoms such as jaundice, abdominal pain and distension, and weight loss, and strive for early consultation, diagnosis, and treatment.
However, it should be noted that some patients with intrahepatic cholangiocarcinoma do not have a history of exposure to these factors, and the exact pathogenesis of intrahepatic cholangiocarcinoma is still unclear and needs further study.