Secular trends in the incidence of cholangiocarcinoma in the USA and the impact of misclassification.
Secular trends in the incidence of cholangiocarcinoma in the USA and the impact of misclassification.
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DOI：
10.1007/s10620-014-3276-2
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发表时间：
2014-12
影响因子：
3.1
通讯作者：
Davila JA
中科院分区：
文献类型：
--
作者：
Tyson GL;Ilyas JA;Duan Z;Green LK;Younes M;El-Serag HB;Davila JA
据报道，在美国，肝内胆管癌（ICC）的发病率有所增加，而肝外胆管癌（ECC）的发病率有所下降或保持稳定。然而，最近的趋势和克拉特金肿瘤的错误分类的影响都是未知的。利用监测、流行病学和最终结果项目数据库，我们计算了1992-1995年、1996-1999年、2000-2003年、2004-2007年4年期间ICC和ECC的年平均年龄调整发病率（AA-IRs）。这些aa - ir是根据正确分类和错误分类的Klatskin肿瘤计算的。aa - ir也根据年龄、性别和种族计算。采用多变量泊松回归模型评价ICC和ECC的长期趋势。ICC的AA-IR在1992-1995年为0.92,2004-2007年为0.93，ECC的AA-IR从1992-1995年的0.70上升到2004-2007年的0.95。ICC的AA-IR无显著趋势（p = 0.07），而ECC在4年期间显著增加（p < 0.001）。在1992-2000年和2001-2007年期间，克拉特金肿瘤占cc的6.7%，分别约有90%和45%被误分类为ICC。调整后的泊松模型显示，由于Klatskin肿瘤的误分类，ICC和ECC的时间趋势没有显著差异。1992年至2007年期间，ICC的发病率保持稳定，只有轻微波动，而ECC的发病率一直在增加。Klatskin肿瘤的错误分类似乎在cc的趋势中没有重要作用。
It has been reported that the incidence of intrahepatic cholangiocarcinoma (ICC) has increased in the USA, while extrahepatic cholangiocarcinoma (ECC) has decreased or remained stable. However, neither the recent trends nor the effects of the misclassification of Klatskin tumors are known. Using the Surveillance, Epidemiology, and End Results program databases, we calculated the average annual age-adjusted incidence rates (AA-IRs) of ICC and ECC in 4-year time periods (1992–1995, 1996–1999, 2000–2003, 2004–2007). These AA-IRs were calculated with misclassified as well as correctly classified Klatskin tumors. AA-IRs were also calculated based on age, sex, and race. Multivariable Poisson regression models were used to evaluate the secular trends of ICC and ECC. The AA-IR of ICC was 0.92 in 1992–1995 and 0.93 in 2004–2007, while the AA-IR of ECC increased from 0.70 in 1992–1995 to 0.95 in 2004–2007. There was no significant trend in AA-IR of ICC (p = 0.07), while there was a significant increase in ECC across the 4-year time periods (p < 0.001). Klatskin tumors comprised 6.7 % of CCs with approximately 90 and 45 % misclassified as ICC during 1992–2000 and 2001–2007, respectively. Adjusted Poisson models showed no significant differences in the temporal trend of ICC or ECC due to misclassification of Klatskin tumors. The incidence of ICC has remained stable between 1992 and 2007 with only slight fluctuations, while the incidence of ECC has been increasing. Misclassification of Klatskin tumors does not appear to play a significant role in the trends of CCs.