Variables

We initially evaluated the pathologic subtypes of HCC-CC, HCC and CC (25,26). Pathologic subtypes for HCC-CC included classical and stem-cell. Pathologic subtypes for HCC included: fibrolamellar, scirrhous, sarcomatoid and lympho-epithelial. Subtypes for CC included: intraductal papillary, intestinal-type, clear, squamous and small cell.

After performing our literature search, we identified risk factors relevant to HCC-CC, HCC alone and CC alone (12-15,17-22). Among these risk factors, cirrhosis, hepatitis B virus (HBV) and hepatitis C virus (HCV) viral infections are evaluated risk factors for HCC-CC (12-15,17-20). For HCC alone, the aforementioned risk factors were included as were the following: portal hypertension, alcoholic fatty liver, aflatoxin, peliosis hepatitis, autoimmune hepatitis (AIH), primary biliary cirrhosis (PBC), granulomatous hepatitis, non-alcoholic fatty liver disease (NAFLD), non-alcoholic steatohepatitis (NASH), hemochromatosis (HCM), glycogen storage disease, Wilson’s disease, porphyria cutanea tarda (PCT), alpha-1 antitrypsin, tyrosinemia, portal vein thrombosis, Budd-Chiari syndrome. For CC we evaluated the following variables: primary sclerosing cholangitis (PSC), cystic disease of the liver, biliary cyst, choledochal cyst, Caroli disease, other congenital malformation of the bile ducts, other congenital malformations of the gall bladder, cholangitis, schistosomiasis, opisthorchiasis, clonochiasis, recurrent cholangitis, and biliary stricture.