Clinical Gastroenterology Vol.29 No.11(1-5)

Theme PSC and PBC -- Recent Progress in Diagnosis and Treatment
Title Primary Sclerosing Cholangitis and Biliary Carcinoma
Publish Date 2014/10
Author Kenji Hirano Department of Gastroenterology, Faculty of Medicine, University of Tokyo
Author Takeo Watanabe Department of Gastroenterology, Faculty of Medicine, University of Tokyo
Author Suguru Mizuno Department of Gastroenterology, Faculty of Medicine, University of Tokyo
Author Minoru Tada Department of Gastroenterology, Faculty of Medicine, University of Tokyo
Author Hiroyuki Isayama Department of Gastroenterology, Faculty of Medicine, University of Tokyo
Author Kazuhiko Koike Department of Gastroenterology, Faculty of Medicine, University of Tokyo
[ Summary ] It is known that primary sclerosing cholangitis (PSC) can be a risk factor for biliary carcinoma including extra- and intrahepatic cholangiocarcinoma (CCA) along with gallbladder carcinoma. In our series, biliary carcinoma occurred in 9 patients (CCA in 7 and gallbladder carcinoma in 2) during follow-ups on 54 patients. The mean period between the occurrence of PSC and biliary carcinoma was 61 months (2-152 months). The mean onset age was 43 years (22-63 years). In our analysis, association with inflammatory bowel disease and normal IgE levels were significant risk factors for biliary carcinoma in cases of PSC. The prognosis was generally poor. All 9 patients have already died. The mean survival period was 17 months (5-41 months). Four patients received surgical treatment, but recurrence was observed later in all cases. Measuring CA19-9 may be useful in the surveillance of biliary carcinoma, although results are not always conclusive.
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