Comparative Analysis Of Clinical Chara-Cteristics In Patients With Liver Flukes And Hepatolithiasis Complicated With Cholangiocarcinoma

Objective To investigate the relationship between liver flukes, hepatolithiasis and cholangiocarcinoma; compare the clinical features between liver flukes and hepatolithiasis complicated with cholangiocarcinon.Methods A retrospective study was performed to analyze the clinical data of 24 patients with liver flukes complicated with cholangiocarcinoma, a total of 56 patients with hepatolithiasis complicated with cholangiocarcinoma, who were diagnosed in the First Affiliated Hospital of Guangxi Medical University from January 1995 to August 2008, was recruited as control group.Results There was no significant difference between the two groups in terms of age, sex, clinical manifestations, liver function and tumor markers ; the incidence of male were significantly higher than that of female in two groups; patients with liver flukes complicated with cholangiocarcinoma which ethnic minorities accounted for 54.2% (13/24), Zhuang Nationality accounted for 37.5% (9/24), fatty liver in clinical manifestations accounted for 41.7% (10/24) and eosinophil count 1.4±0.6×10~9/L, were higher than those with hepatolithiasis complicated with cholangiocarcinoma (P<0.05); Ultrasonography, ERCP and CT scan showed the positive rate of cystic dilatation of small bile ducts in the hepatic subcapsular of patients with liver flukes complicated with cholangiocarcinoma were 37.5% (9/24), 50.0% (4/8) and 41.7% (10/24) respectively, but with that of 10.7% (6/56), 12.5% (2/16), 8.9% (5/56) in patients with hepatolithiasis complicated with cholangiocarcinoma (P <0.05); the tumor lesions located at left and right lobe in patients with liver flukes complicated with cholangiocarcinoma were 4.2% (1/24) and 33.3% (8/24) respectively, but with that of 26.8% (15/56) and 7.1% (4/56) in patients with hepatolithiasis complicated with cholangiocarcinoma (P <0.05). Most of histological type of lesions were adenocarcinoma in two groups of patients, and the proportion of poorly differentiated adenocarcinoma in the two group were 33.3% (9/24) and 30.3% (18/56) respectively (P> 0.05).Conclusions Cholnagioeareinoma may be related to liver fluke infection and hepatolithiasis, Long-term liver fluke infection may be a risk factor for occurrence of cholangiocarcinoma. The cystic dilatation of small bile ducts in the hepatic subcapsular of patients with liver flukes complicated with cholangiocarcinoma is one of characteristic changes of imaging performance, combining with epidemic history, find eggs through the fecal examination and imaging examination can confirm the diagnosis.