Observational Study
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World J Gastroenterol. Sep 21, 2014; 20(35): 12615-12620
Published online Sep 21, 2014. doi: 10.3748/wjg.v20.i35.12615
Risk factors for combined hepatocellular-cholangiocarcinoma: A hospital-based case-control study
Yan-Ming Zhou, Xiao-Feng Zhang, Lu-Peng Wu, Cheng-Jun Sui, Jia-Mei Yang
Yan-Ming Zhou, Lu-Peng Wu, Department of Hepato-Biliary-Pancreato-Vascular Surgery, the First Affiliated Hospital of Xiamen University, Xiamen 361003, Fujian Province, China
Xiao-Feng Zhang, Cheng-Jun Sui, Jia-Mei Yang, Department of Special Treatment and Liver Transplantation, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China
Author contributions: Zhou YM and Zhang XF contributed equally to this work; Zhou YM and Zhang XF participated in the design and coordination of the study, carried out the critical appraisal of studies and wrote the paper; Wu LP, Sui CJ, and Yang JM made substantial contributions to acquisition, analysis and interpretation of data; all authors gave final approval of the version to be published.
Correspondence to: Jia-Mei Yang, MD, Department of Special Treatment and Liver Transplantation, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, 225 Changhai Road, Shanghai 200438, China. yjm1952@sina.cn
Telephone: +86-21-65564166 Fax: +86-21-65562400
Received: February 14, 2014
Revised: May 22, 2014
Accepted: June 14, 2014
Published online: September 21, 2014
Processing time: 217 Days and 0.7 Hours
Abstract

AIM: To identify risk factors contributing to the development of combined hepatocellular-cholangiocarcinoma (CHC) in China.

METHODS: One hundred and twenty-six patients with CHC and 4:1 matched healthy controls were interviewed during the period from February 2000 to October 2012. Logistic regression analysis was used to calculate odds ratios (OR) and 95% confidence intervals (CI) for each risk factor.

RESULTS: Univariate analysis showed that the significant risk factors for CHC development were hepatitis B virus (HBV) infection, heavy alcohol consumption, a family history of liver cancer, and diabetes mellitus. Multivariate stepwise logistic regression analysis showed that HBV infection (OR = 19.245, 95%CI: 13.260-27.931) and heavy alcohol consumption (OR = 2.186, 95%CI: 1.070-4.466) were independent factors contributing to the development of CHC.

CONCLUSION: HBV infection and heavy alcohol consumption may play a role in the development of CHC in China.

Keywords: Risk factors; Combined hepatocellular-cholangiocarcinoma; Hepatitis B virus; Alcohol consumption; Epidemiology

Core tip: Combined hepatocellular-cholangiocarcinoma (CHC) is a rare form of primary liver malignancy that includes intimately mixed elements of both hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC). Although risk factors for the development of HCC and ICC have been studied extensively, the etiology of CHC remains unknown. We carried out a hospital-based case-control study to identify risk factors contributing to the development of CHC in China.