ABSTRACT

Introduction: Cholangiocarcinoma (CCA) is a malignancy which arises from the biliary epithelium. Carcinogenesis of CCA is mainly linked to aberrant glucose metabolism and creation of an immunosuppressive environment around normal biliary epithelium. The incidence of CCA is higher in the East due to Opisthorchis viverrini, an endemic liver fluke. CCA has also be attributed to genetic, metabolic, and lifestyle risk factors.

Areas covered: Differences in epidemiological risk factors are associated with varying phenotypes of CCA. Metabolic risk factors include diabetes, obesity, nonalcoholic fatty liver disease (NAFLD)/nonalcoholic steatohepatitis (NASH), dyslipidemia, and metabolic syndrome. Inherited metabolic risk factors include Wilson’s disease and hemochromatosis. Metabolic disease is associated with a higher risk of CCA, with higher risk for the intrahepatic form. In this review, the authors provide an overview of available evidence regarding metabolic conditions associated with the development of CCA.

Expert opinion: Metabolic disease is associated with a higher risk of intrahepatic CCA compared to its extrahepatic or hilar counterpart. As rates of obesity and metabolic syndrome increase, particularly in the West, it is conceivable that the incidence of CCA will also rise in the next years.

摘要

简介：胆管癌（CCA）是一种起源于胆管上皮的恶性肿瘤。CCA 的致癌作用主要与异常的葡萄糖代谢和在正常胆管上皮周围形成免疫抑制环境有关。由于Opisthorchis viverrini是一种地方性肝吸虫，东方的 CCA 发病率较高。CCA 也归因于遗传、代谢和生活方式的风险因素。

涵盖的领域：流行病学风险因素的差异与 CCA 的不同表型有关。代谢危险因素包括糖尿病、肥胖、非酒精性脂肪性肝病 (NAFLD)/非酒精性脂肪性肝炎 (NASH)、血脂异常和代谢综合征。遗传性代谢危险因素包括威尔逊病和血色素沉着病。代谢性疾病与更高的 CCA 风险相关，肝内形式的风险更高。在这篇综述中，作者概述了与发生 CCA 相关的代谢状况的现有证据。

专家意见：与肝外或肝门对应物相比，代谢性疾病与肝内 CCA 的风险更高有关。随着肥胖和代谢综合征发病率的增加，尤其是在西方，可以想象，CCA 的发病率在未来几年也将上升。