2022 Volume 36 Issue 2 Pages 145-150
In the biliary tract, inflammation and carcinogenesis are closely associated with each other. Gallstones provoke inflammation in the bile duct, which can cause development of carcinoma. The relative risk of hepatolithiasis and choledochal stones for development of carcinoma is 17.64. Pancreaticobiliary maljunction causes reflux of pancreatic juice and chronic inflammation with or without dilatation in the bile duct. Carcinoma can be found in 20% of the dilated type and 40% of the non-dilated type of pancreaticobiliary maljunction. Primary sclerosing cholangitis is associated with carcinoma in 7% of patients. Liver fluke causes chronic inflammation and carcinoma. Biliary intraepithelial neoplasia and intraductal papillary neoplasm, precursor lesions in the bile duct, are found frequently in the bile duct with inflammation. In genome analyses of bile duct carcinomas, the mutation signature indicates inflammation-associated APOBEC activation as an etiology. Peribiliary glands harbor stem cells that can become a source for regeneration of bile duct epithelium. Inflammation is supposed to accelerate regeneration of biliary epithelia, which may increase a risk for development of carcinoma.
