Alcoholic liver disease and risk of cholangiocarcinoma: a systematic review and meta-analysis
Received 18 August 2018
Accepted for publication 19 October 2018
Published 20 November 2018 Volume 2018:11 Pages 8211—8219
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Amy Norman
Peer reviewer comments 2
Editor who approved publication: Dr Leo Jen-Liang Su
Jianping Xiong,1,* ZiJun Yin,2,* Weiyu Xu,1,* Zheng Shen,3 Ye Li,1 Xin Lu1
1Department of Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing 100730, China; 2Department of Oncology, The First Affiliated Hospital, Jinan University, Guangzhou 510630, China; 3Department of Orthopaedics, Anhui No. 2 Provincial People’s Hospital, Hefei 230041, China
*These authors contributed equally to this work
Background: With the purpose of elevating the risk of cholangiocarcinoma (CCA), alcoholic liver disease (ALD) was shown. Nonetheless, the findings were controversial. Herein, a meta-analysis and a systematic review were conducted to study the relation as mentioned above.
Methods: This study searched PubMed, EMBASE, and SI Web of Science carefully for the related studies published prior to March 2018, followed by the random-effects model to calculate the values of pooled risk ratio with 95% CIs. In addition, the analyses of sensitivity and subgroup were carried out to further confirm the stability of the outcomes.
Results: Seven articles, consisting of 413,483 healthy controls and 8,962 CCA patients, were included in this meta-analysis. When compared with normal controls, patients with ALD had an enhanced 3.92-fold CCA risk, with studies being heterogeneous (95% CI =1.96–5.07; OR =3.92; I2 =70.2%). However, subgroup analysis showed that ALD had the enhanced risk of intrahepatic cholangiocarcinoma (ICC), instead of extrahepatic cholangiocarcinoma (ECC) (ICC: 95% CI =3.06–5.92, OR =4.49; ECC: 95% CI =0.90–3.35, OR =2.12). Additionally, when the analysis was stratified by the geographic area, positive association was observed only in western countries rather than eastern countries (western nations: 95% CI =3.34–6.96, OR =5.15; eastern nations: 95% CI =0.38–3.91, OR =2.14). And no essential bias was published.
Conclusion: ALD was greatly associated with the enhanced risk of CCA by 3.92-fold, especially in the ICC.
Keywords: alcoholic liver disease, cholangiocarcinoma, biliary tract neoplasms, meta-analysis
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