Alcoholic liver disease and risk of cholangiocarcinoma: a systematic review and meta-analysis

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.

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.

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.

ALD was greatly associated with the enhanced risk of CCA by 3.92-fold, especially in the ICC.