PMID- 27251649 OWN - NLM STAT- MEDLINE DCOM- 20171002 LR - 20181113 IS - 1471-2407 (Electronic) IS - 1471-2407 (Linking) VI - 16 DP - 2016 Jun 2 TI - Ultrasound screening for cholangiocarcinoma could detect premalignant lesions and early-stage diseases with survival benefits: a population-based prospective study of 4,225 subjects in an endemic area. PG - 346 LID - 10.1186/s12885-016-2390-2 [doi] LID - 346 AB - BACKGROUND: Thailand has a high incidence of cholangiocarcinoma (CCA), particularly in the north and northeastern regions. Most CCA patients come at a late, unresectable stage and presently no optimal screening test for CCA has been established. We determined the prevalence of CCA in a remote northern village and explored if screening could lead to early detection and survival benefits. METHODS: A 5-year population-based study was started in October, 2011 for consented Thai individuals, aged 30-60 years. The screening program comprised blood testing, stool examination and serial ultrasonography every 6 months. RESULTS: During the first 3 years, 4,225 eligible individuals were enrolled. CCA was detected in 32 patients, with a mean age of 51.9 years (41-62 years), and 21/32 cases were at a curative resectable stage. The prevalence rate of CCA was 165.7 per 100,000 and one- and two-year incidence rate was 236.7/100,000 and 520.7/100,000, respectively. One- and 2-year overall survival rates of CCA patients were 90.9 and 61.5 %, respectively. Prognosis was better in resectable cases with 100 % 1-year and 77.8 % 2-year survival rates. Interestingly, premalignant pathological lesions (stage 0) were identified in 11 cases with 100 % 3-year survival rate. Serum biomarkers and alkaline phosphatase were not sufficient to detect early-stage disease. In 22 patients, stool samples were positive for Opistorchis viverrini, based on polymerase chain reaction. CONCLUSION: Detection of premalignant lesions and early-stage resectable CCA by ultrasonography resulted in improved clinical outcome. Ultrasonography should be offered as a first screening tool for CCA in an endemic area until other useful biological markers become available. FAU - Sungkasubun, Prakongboon AU - Sungkasubun P AD - Chulabhorn Hospital, 54 Kamphaeng Phet 6 Road, Laksi, Bangkok, 10210,, Thailand. FAU - Siripongsakun, Surachate AU - Siripongsakun S AD - Chulabhorn Hospital, 54 Kamphaeng Phet 6 Road, Laksi, Bangkok, 10210,, Thailand. FAU - Akkarachinorate, Kunlayanee AU - Akkarachinorate K AD - Ban Luang Hospital, 191 Pa Kha Luang, Ban Luang, Nan, 55190, Thailand. FAU - Vidhyarkorn, Sirachat AU - Vidhyarkorn S AD - Chulabhorn Hospital, 54 Kamphaeng Phet 6 Road, Laksi, Bangkok, 10210,, Thailand. FAU - Worakitsitisatorn, Akeanong AU - Worakitsitisatorn A AD - Chulabhorn Hospital, 54 Kamphaeng Phet 6 Road, Laksi, Bangkok, 10210,, Thailand. FAU - Sricharunrat, Thaniya AU - Sricharunrat T AD - Chulabhorn Hospital, 54 Kamphaeng Phet 6 Road, Laksi, Bangkok, 10210,, Thailand. FAU - Singharuksa, Sutida AU - Singharuksa S AD - Chulabhorn Hospital, 54 Kamphaeng Phet 6 Road, Laksi, Bangkok, 10210,, Thailand. FAU - Chanwat, Rawisak AU - Chanwat R AD - National Cancer Institute of Thailand, 268/1 Rama VI Road, Ratchathewi, Bangkok, 10400, Thailand. FAU - Bunchaliew, Chairat AU - Bunchaliew C AD - National Cancer Institute of Thailand, 268/1 Rama VI Road, Ratchathewi, Bangkok, 10400, Thailand. FAU - Charoenphattharaphesat, Sirima AU - Charoenphattharaphesat S AD - Chulabhorn Hospital, 54 Kamphaeng Phet 6 Road, Laksi, Bangkok, 10210,, Thailand. FAU - Molek, Ruechuta AU - Molek R AD - Chulabhorn Hospital, 54 Kamphaeng Phet 6 Road, Laksi, Bangkok, 10210,, Thailand. FAU - Yimyaem, Maneenop AU - Yimyaem M AD - Chulabhorn Hospital, 54 Kamphaeng Phet 6 Road, Laksi, Bangkok, 10210,, Thailand. FAU - Sornsamdang, Gaidganok AU - Sornsamdang G AD - Chulabhorn Hospital, 54 Kamphaeng Phet 6 Road, Laksi, Bangkok, 10210,, Thailand. FAU - Soonklang, Kamonwan AU - Soonklang K AD - Chulabhorn Hospital, 54 Kamphaeng Phet 6 Road, Laksi, Bangkok, 10210,, Thailand. FAU - Wittayasak, Kasiruck AU - Wittayasak K AD - Chulabhorn Hospital, 54 Kamphaeng Phet 6 Road, Laksi, Bangkok, 10210,, Thailand. FAU - Auewarakul, Chirayu U AU - Auewarakul CU AD - Chulabhorn Hospital, 54 Kamphaeng Phet 6 Road, Laksi, Bangkok, 10210,, Thailand. AD - Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700, Thailand. FAU - Mahidol, Chulabhorn AU - Mahidol C AD - Chulabhorn Hospital, 54 Kamphaeng Phet 6 Road, Laksi, Bangkok, 10210,, Thailand. cmah2500@gmail.com. AD - Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700, Thailand. cmah2500@gmail.com. AD - Chulabhorn Research Institute, 54 Kamphaeng Phet 6 Road, Laksi, Bangkok, 10210, Thailand. cmah2500@gmail.com. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20160602 PL - England TA - BMC Cancer JT - BMC cancer JID - 100967800 SB - IM MH - Adult MH - Bile Duct Neoplasms/*diagnostic imaging/mortality/surgery MH - Bile Ducts, Intrahepatic/diagnostic imaging MH - Cholangiocarcinoma/*diagnostic imaging/mortality/surgery MH - Disease-Free Survival MH - Early Detection of Cancer MH - Endemic Diseases MH - Female MH - Humans MH - Male MH - Middle Aged MH - Prospective Studies MH - Ultrasonography PMC - PMC4890519 OTO - NOTNLM OT - Cancer screening OT - Cholangiocarcinoma OT - Early detection OT - Premalignant lesions OT - Tumor markers OT - Ultrasonography EDAT- 2016/06/03 06:00 MHDA- 2017/10/03 06:00 PMCR- 2016/06/02 CRDT- 2016/06/03 06:00 PHST- 2015/12/23 00:00 [received] PHST- 2016/05/26 00:00 [accepted] PHST- 2016/06/03 06:00 [entrez] PHST- 2016/06/03 06:00 [pubmed] PHST- 2017/10/03 06:00 [medline] PHST- 2016/06/02 00:00 [pmc-release] AID - 10.1186/s12885-016-2390-2 [pii] AID - 2390 [pii] AID - 10.1186/s12885-016-2390-2 [doi] PST - epublish SO - BMC Cancer. 2016 Jun 2;16:346. doi: 10.1186/s12885-016-2390-2.