Factors Associated with Periductal Fibrosis Daignosied by Ultrasonography Screening in Northeast Thailand

Cholangiocarcinoma (CCA), also known as bile duct cancer arising along the intraor extra-hepatic biliary tree. It accounts for approximately 10–25% of all hepatobiliary malignancies worldwide (Gatto et al., 2010). CCA remains an important public health problem in countries of mainland Southeast Asia, especially in northeast Thailand, which has been reported the world’s highest incidence of CCA (Sripa and Pairojkul, 2008; Moore et al., 2010; Shin et al., 2010). The incidence is rather high accounting for 87.7 per 100,000 in males and 36.3 per 100,000 in females (Khuhaprema T et al., 2010). Since, Thailand is an endemic area of liver flukes (Opisthorchis viverrini; OV), a major etiology of CCA, that cause chronic inflammation and are considered to be carcinogens (Rizvi and Gores, 2013). Most subjects with CCA have a poor prognosis and