108年:內專
有關膽管癌(cholangiocarcinoma)的敘述，下列何者並不正確?
AThe incidence of cholangiocarcinoma has been increasing in recent years
BPrimary sclerosing cholangitis and hepatitis C virus infection are associated with cholangiocarcinoma
CMost patients present due to an abnormal screening ultrasound, without symptoms
DAsians infected with liver flukes have an increased risk of cholangiocarcinoma
ESurgical resection may achieve 40% 5-year Survival with an R0 resection
詳細解析
本題觀念：
本題聚焦於膽管癌（cholangiocarcinoma）的流行病學趨勢、已知危險因子、臨床首發方式及外科治療後的存活率。
選項分析
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選項A
近年來多項流行病學研究都指出，西方國家（尤其是歐洲、美國、澳洲）內肝型膽管癌（intrahepatic cholangiocarcinoma，iCCA）的發生率呈明顯上升趨勢，雖然肝外型膽管癌（extrahepatic CCA）則相對穩定或微幅下降(pubmed.ncbi.nlm.nih.gov, pmc.ncbi.nlm.nih.gov)。 -
選項B
原發性硬化性膽管炎（primary sclerosing cholangitis，PSC）為西方最常見的已知膽管癌危險因子，PSC患者長期慢性膽道發炎，20–40%的個案最終可能併發CCA；此外，慢性HCV感染在多篇病例對照及族群研究中也被證實與CCA風險增加相關，HCV感染者相對風險約1.8倍([europepmc.org](https://europep
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