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Authors Xiong J, Yin Z, Xu W, Shen Z, Li Y, Lu X
Received 18 August 2018
Accepted for publication 19 October 2018
Published 20 November 2018 Volume 2018:11 Pages 8211—8219
DOI https://doi.org/10.2147/OTT.S184444
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
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