Viral hepatitis-associated intrahepatic cholangiocarcinoma shares common disease processes with hepatocellular carcinoma

Bile duct cells and hepatocytes differentiate from the same hepatic progenitor cells. To investigate the possible association of viral hepatitis B and C with intrahepatic cholangiocarcinoma (ICC), we conducted a retrospective case-control study using univariate and multivariate logistic analyses to identify risk factors for ICC. Besides hepatic lithiasis (25.6%; P0.001), seropositivity for hepatitis B surface antigen (37.5% of all ICC patients; odds ratio (OR) 4.985, P0.001) and seropositivity for hepatitis C antibodies (13.1%; OR2.709; P0.021) are the primary independent risk factors for ICC. Cirrhosis exerted synergic effects on the development of ICC. We compared the age distributions of viral-hepatitis associated ICC to that of viral hepatitis-associated hepatocellular carcinoma (HCC). The mean age of ICC patients with viral hepatitis B (56.411.1 years) were 9 years younger than that of ICC patients with viral hepatitis C (65.69.17 years), similar to that observed in HCC. The incidence ratio of HCC: ICC: CHC (combined hepatocellular cholangiocarcinoma) in our population was 233: 17: 1 consistent with the theoretic ratio of hepatocyte number to cholangiocyte number in the liver. Our findings indicated that both viral hepatitis-associated ICC and HCC shared common disease process for carcinogenesis and, possibly, both arose from the hepatic progenitor cells.