Editing Primary sclerosing cholangitis (section)

== Complications ==
[[Cholangiocarcinoma]] (CCA) represents a major complication and the leading cause of death in patients with primary sclerosing cholangitis (PSC), with a lifetime prevalence ranging from 6-13%. Patients with PSC have a 400-600 fold higher risk of developing CCA compared to the general population, with an annual risk between 0.5-1.5%. Notably, 30-50% of PSC-associated CCAs are diagnosed within the first year after PSC diagnosis, and up to 80% of patients die within one year of CCA detection. Risk factors include advanced age, male sex, concomitant inflammatory bowel disease, and high-grade biliary strictures. The development of CCA follows a multistep [[carcinogenesis]] model involving chronic inflammation, which progresses from damaged biliary epithelium to dysplasia and eventually invasive cancer, with molecular mechanisms including inflammatory pathways, oxidative stress, genetic alterations (commonly affecting [[p53]]), and [[Epigenetics|epigenetic]] changes that create an aberrant phenotype in [[Cholangiocyte|cholangiocytes]].<ref name=":3">{{Cite journal |last1=Catanzaro |first1=Elisa |last2=Gringeri |first2=Enrico |last3=Burra |first3=Patrizia |last4=Gambato |first4=Martina |date=2023-10-11 |title=Primary Sclerosing Cholangitis-Associated Cholangiocarcinoma: From Pathogenesis to Diagnostic and Surveillance Strategies |journal=Cancers |language=en |volume=15 |issue=20 |pages=4947 |doi=10.3390/cancers15204947 |doi-access=free |issn=2072-6694 |pmc=10604939 |pmid=37894314}}</ref>