Proton pump inhibitors and odds of cholangiocarcinoma: A retrospective case-control study
Jianping Xiong
Department of Interventional Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Search for more papers by this authorYaqin Wang
Department of Interventional Radiology, The First Affiliated Hospital of China Medical University, Shenyang, China
Search for more papers by this authorWeiyu Xu
Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Search for more papers by this authorZhisong Liu
Faculty of Statistics, Tianjin University of Finance and Economics, Tianjin, China
Search for more papers by this authorHaochen Wang
Department of Interventional Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Search for more papers by this authorZhiyuan Zhang
Department of Interventional Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Search for more papers by this authorYanjing Han
Department of Interventional Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Search for more papers by this authorChao Yin
Department of Interventional Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Search for more papers by this authorShasha Cao
Department of Interventional Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Search for more papers by this authorZheran Yang
Department of Interventional Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Search for more papers by this authorTianhao Su
Department of Interventional Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Search for more papers by this authorJian Wei
Department of Interventional Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Search for more papers by this authorGuang Chen
Department of Interventional Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Search for more papers by this authorCorresponding Author
Long Jin
Department of Interventional Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Correspondence
Long Jin, Interventional Radiology, Beijing Friendship Hospital, Capital Medical University, 95 Yong An Road, Xicheng District, Beijing 100050, China.
Email: [email protected].
Search for more papers by this authorJianping Xiong
Department of Interventional Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Search for more papers by this authorYaqin Wang
Department of Interventional Radiology, The First Affiliated Hospital of China Medical University, Shenyang, China
Search for more papers by this authorWeiyu Xu
Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Search for more papers by this authorZhisong Liu
Faculty of Statistics, Tianjin University of Finance and Economics, Tianjin, China
Search for more papers by this authorHaochen Wang
Department of Interventional Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Search for more papers by this authorZhiyuan Zhang
Department of Interventional Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Search for more papers by this authorYanjing Han
Department of Interventional Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Search for more papers by this authorChao Yin
Department of Interventional Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Search for more papers by this authorShasha Cao
Department of Interventional Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Search for more papers by this authorZheran Yang
Department of Interventional Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Search for more papers by this authorTianhao Su
Department of Interventional Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Search for more papers by this authorJian Wei
Department of Interventional Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Search for more papers by this authorGuang Chen
Department of Interventional Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Search for more papers by this authorCorresponding Author
Long Jin
Department of Interventional Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Correspondence
Long Jin, Interventional Radiology, Beijing Friendship Hospital, Capital Medical University, 95 Yong An Road, Xicheng District, Beijing 100050, China.
Email: [email protected].
Search for more papers by this authorJianping Xiong, Yaqin Wang, and Weiyu Xu contributed equally to this work.
Abstract
Background & Aims
Proton pump inhibitors (PPIs) have been reported to be associated with cholangitis and might possibly be carcinogenic. However, few studies have been conducted to investigate the association of PPIs with cholangiocarcinoma (CCA). Thus, a hospital-based case-control study was carried out in China to explore the association between PPIs and CCA.
Methods
In this study, 1468 CCA cases (826 intrahepatic cholangiocarcinoma (ICC) and 642 extrahepatic cholangiocarcinoma (ECC)) were included, which were observed at Beijing Friendship Hospital, from February 2002 to October 2018. We retrospectively extracted PPI use and other possible risk factors from clinical records, followed by an investigation of the relationship with CCA via calculation of odds ratios (ORs), adjusted odds ratios (AORs), and 95% confidence intervals (CIs) using logistic regression analysis.
Results
PPIs were used by 135 (9.2%) CCA cases and 173 (5.9%) controls. We found that PPI use was associated with a 1.61-fold elevated CCA odds (P < .001) (AOR = 1.61, 95% CI = 1.28-2.05; P < .001). After stratification by CCA subtypes, the AORs of PPIs were consistent for both CCA subtypes, with ORs of 1.36 (AOR = 1.36, 95% CI = 1.02-1.83; P = .003) and 1.95 (AOR = 1.95, 95% CI = 1.46-2.62; P < .001) for ICC and ECC respectively. Our results also showed that PPI use was slightly linked to the odds of CCA in a dose-dependent manner.
Conclusion
PPI use was correlated with a significant 61% increased odds of CCA, particularly in the ECC. However, the retrospective design and observational nature cannot establish causation. Larger scale, multi-centre prospective studies are required for further validation.
CONFLICTS OF INTEREST
The authors report no conflicts of interest in relation to this work.
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