Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
6094439 | Gastroenterology | 2013 | 15 Pages |
Abstract
Cholangiocarcinomas (CCAs) are hepatobiliary cancers with features of cholangiocyte differentiation; they can be classified anatomically as intrahepatic CCA (iCCA), perihilar CCA (pCCA), or distal CCA. These subtypes differ not only in their anatomic location, but in epidemiology, origin, etiology, pathogenesis, and treatment. The incidence and mortality of iCCA has been increasing over the past 3 decades, and only a low percentage of patients survive until 5 years after diagnosis. Geographic variations in the incidence of CCA are related to variations in risk factors. Changes in oncogene and inflammatory signaling pathways, as well as genetic and epigenetic alterations and chromosome aberrations, have been shown to contribute to the development of CCA. Furthermore, CCAs are surrounded by a dense stroma that contains many cancer-associated fibroblasts, which promotes their progression. We have gained a better understanding of the imaging characteristics of iCCAs and have developed advanced cytologic techniques to detect pCCAs. Patients with iCCAs usually are treated surgically, whereas liver transplantation after neoadjuvant chemoradiation is an option for a subset of patients with pCCAs. We review recent developments in our understanding of the epidemiology and pathogenesis of CCA, along with advances in classification, diagnosis, and treatment.
Keywords
PDGFERBB2KRASeGFPchemokine (C-X-C motif) receptor 4ERKCCAPSCDCCACXCR4MIRFGFRPCCAERCCA19-9HGFIDHTP53iCCAECMEGFRCAFmet proto-oncogenePI3Kα-SMAMMPHCCMAPKMcl1Phosphatidylinositol-4,5-bisphosphate 3-kinaseSTATcarbohydrate antigen 19-9MRIα-smooth muscle actinIsocitrate dehydrogenaseinterleukin 6Magnetic resonance imagingmyeloid cell leukemia sequence 1computed tomographyEMTKirsten rat sarcoma viral oncogene homologextracellular signal regulated kinaseIL 6Hepatocyte growth factorplatelet-derived growth factorPhosphatidyl inositolfluorescence in situ hybridizationCancer-associated fibroblastscancer-associated fibroblastExtracellular matrixmatrix metalloproteinaseFishSignal transducer and activator of transcriptionMETMicroRNAodds ratioHBVHCVHepatitis C virushepatitis B virusMolecular pathogenesistumor protein 53enhanced green fluorescent proteinmitogen-activated protein kinaseHepatocellular carcinomaPrimary sclerosing cholangitisIntrahepatic cholangiocarcinomaCholangiocarcinomaperihilar cholangiocarcinomadistal cholangiocarcinomaendoscopic retrograde cholangiographyEpithelial–mesenchymal transitionfibroblast growth factor receptor
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Authors
Sumera Rizvi, Gregory J. Gores,