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Association between periductal fibrosis and bile duct dilatation among a population at high risk of cholangiocarcinoma: A cross-sectional study of cholangiocarcinoma screening in Northeast Thailand

Chamadol, Nittaya; Khuntikeo, Narong; Thinkhamrop, Bandit; Thinkhamrop, Kavin; Suwannatrai, Apiporn T.; Kelly, Matthew; Promthet, Supannee

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Objectives To assess associations between periductal fibrosis (PDF) and bile duct dilatation (BDD) in ultrasonography (US) screening of population at risk of cholangiocarcinoma (CCA) due to residence in an endemic area for Opisthorchis viverrini. CCA survival rates are low, and early identification of risk factors is essential. BDD is one symptom that can identify patients at risk of CCA. Detection of PDF by US can also identify at-risk patients, at an earlier stage of CCA development....[Show more]

dc.contributor.authorChamadol, Nittaya
dc.contributor.authorKhuntikeo, Narong
dc.contributor.authorThinkhamrop, Bandit
dc.contributor.authorThinkhamrop, Kavin
dc.contributor.authorSuwannatrai, Apiporn T.
dc.contributor.authorKelly, Matthew
dc.contributor.authorPromthet, Supannee
dc.date.accessioned2020-01-09T01:03:39Z
dc.date.available2020-01-09T01:03:39Z
dc.identifier.issn2044-6055
dc.identifier.urihttp://hdl.handle.net/1885/196694
dc.description.abstractObjectives To assess associations between periductal fibrosis (PDF) and bile duct dilatation (BDD) in ultrasonography (US) screening of population at risk of cholangiocarcinoma (CCA) due to residence in an endemic area for Opisthorchis viverrini. CCA survival rates are low, and early identification of risk factors is essential. BDD is one symptom that can identify patients at risk of CCA. Detection of PDF by US can also identify at-risk patients, at an earlier stage of CCA development. Identification of association between PDF and BDD will inform screening practices for CCA risk, by increasing the viability of PDF screening for CCA risk. Setting Nine tertiary care hospitals in Northeast Thailand. Design Cross-sectional study. Participants Study subjects in the Cholangiocarcinoma Screening and Care Program (CASCAP) in Northeast Thailand. CASCAP inclusion criteria are all residents of Northeast Thailand aged ≥40 years. Participants are recruited through CCA screening centres and through primary healthcare units. So far, 394 026 have been enrolled. Methods PDF and BDD were identified through US. PDF was categorised into three groups, PDF1, 2 and 3, depending on their high echo locality in the peripheral, segmental and main bile duct, respectively. Associations between PDF and BDD were determined by adjusted OR and 95% CI using multiple logistic regression. Results BDD was found in 6.6% of PDF3, 1.7% of PDF2 and 1.4% of PDF1 cases. Among PDF cases, especially in PDF3, BDD was found in men more than in women (8.9% and 4.6%, respectively). Compared with non-PDF, the association between PDF3 and BDD was highly significant (adjusted OR=5.74, 95%CI 4.57 to 7.21, p<0.001). Conclusions Our findings reveal that there is a relationship between PDF and BDD, which is associated with CCA. Therefore, PDF can also be an indicator for suspected CCA diagnosis through US
dc.description.sponsorshipThe study was also supported by the Data Management and Statistical Analysis Center (DAMASAC), Faculty of Public Health, KKU, Thailand. This work was supported by KKU through CASCAP (Grant No. CASCAP 1/60), the National Research Council of Thailand through the Medical Research Network of the Consortium of Thai Medical Schools (Grant No. MRF.59-076) and National Research Council of Thailand (NRCT/2559-134).
dc.format.mimetypeapplication/pdf
dc.language.isoen_AU
dc.publisherBMJ Publishing Group
dc.rights© Author(s) (or their employer(s)) 2019
dc.rights.urihttps://creativecommons.org/licenses/by-nc/4.0/
dc.sourceBMJ Open
dc.titleAssociation between periductal fibrosis and bile duct dilatation among a population at high risk of cholangiocarcinoma: A cross-sectional study of cholangiocarcinoma screening in Northeast Thailand
dc.typeJournal article
local.description.notesImported from ARIES
local.identifier.citationvolume9
dc.date.issued2019
local.identifier.absfor111706 - Epidemiology
local.identifier.absfor111716 - Preventive Medicine
local.identifier.absfor111712 - Health Promotion
local.identifier.ariespublicationu3102795xPUB1132
local.publisher.urlhttps://authors.bmj.com/open-access/
local.type.statusPublished Version
local.contributor.affiliationChamadol, Nittaya, Khon Kaen University
local.contributor.affiliationKhuntikeo, Narong, Khon Kaen University
local.contributor.affiliationThinkhamrop, Bandit, Khon Kaen University
local.contributor.affiliationThinkhamrop, Kavin, Khon Kaen University
local.contributor.affiliationSuwannatrai, Apiporn T., Khon Kaen University
local.contributor.affiliationKelly, Matthew, College of Health and Medicine, ANU
local.contributor.affiliationPromthet, Supannee, Khon Kaen University
local.bibliographicCitation.issue3
local.bibliographicCitation.startpage1
local.bibliographicCitation.lastpage9
local.identifier.doi10.1136/bmjopen-2018-023217
local.identifier.absseo920503 - Health Related to Specific Ethnic Groups
local.identifier.absseo920412 - Preventive Medicine
local.identifier.absseo920405 - Environmental Health
dc.date.updated2019-08-25T08:17:20Z
local.identifier.scopusID2-s2.0-85063303092
dcterms.accessRightsOpen Access
dc.provenanceThis is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
dc.rights.licenseCreative Commons Attribution Non Commercial (CC BY-NC 4.0) license
CollectionsANU Research Publications

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