Primary sclerosing cholangitis (PSC) — confirmed by characteristic cholangiographic findi...

Детермінований перегляд YAML-сутності з джерельної бази. Клінічний авторитет лишається за вказаними source ID та статусом клінічного sign-off.

ID	`RF-PSC-CHOLANGIOCARCINOMA-PREVENTION`
Тип	Тривожна ознака
Статус	переглянуто 2026-05-18 \| очікує клінічного підпису
Хвороби	`DIS-CHOLANGIOCARCINOMA` `DIS-CRC` `DIS-HCC`
Джерела	`SRC-AASLD-HCC-2023` `SRC-NCCN-COLON-2025` `SRC-NCCN-HEPATOBILIARY`

Походження тривожної ознаки

Визначення	Primary sclerosing cholangitis (PSC) — confirmed by characteristic cholangiographic findings on MRCP or ERCP (multifocal intra-/extra- hepatic biliary strictures with intervening dilatation, beaded appearance) and/or liver biopsy (concentric periductal fibrosis, onion-skin pattern). Includes PSC-IBD subgroup (very high risk for both CRC and cholangiocarcinoma) and PSC with dominant biliary stricture (additional cholangiocarcinoma risk requiring focused diagnostic workup). No current cholangiocarcinoma, gallbladder cancer, or HCC diagnosis. PSC is the strongest known risk factor for cholangiocarcinoma — lifetime risk ~10-15% (vs ~0.01% in general population); annual incidence ~0.5-1.5% per year. Gallbladder cancer risk also elevated ~10-fold. Cirrhotic PSC adds HCC risk in the general cirrhosis pattern. Surveillance with MRI/MRCP + CA 19-9 ± ERCP for dominant strictures enables earlier d...
Клінічний напрям	investigate
Категорія	other

Логіка спрацьовування

{
  "any_of": [
    {
      "finding": "primary_sclerosing_cholangitis_diagnosis_confirmed",
      "value": true
    },
    {
      "finding": "primary_sclerosing_cholangitis_with_ibd",
      "value": true
    },
    {
      "finding": "primary_sclerosing_cholangitis_with_dominant_stricture",
      "value": true
    }
  ],
  "type": "lab_value"
}

Нотатки

v0.3 chronic-condition prevention pilot — PSC. Prevention-persona RedFlag (CHARTER §3 amended 2026-05-18 Path A, HCP-mediated). Fires when patient profile shows confirmed PSC (any trigger) AND no current cholangiocarcinoma / gallbladder cancer / HCC diagnosis. Engine routes to PreventionPlan with 2 tracks: intensified imaging surveillance (annual MRI/MRCP + CA 19-9 ± ERCP for dominant strictures, annual colonoscopy if PSC-IBD) (IND-PSC-CHOLANGIOCARCINOMA-PREVENTION-SURVEILLANCE) as standard; routine q2-3y imaging surveillance (IND-PSC-CHOLANGIOCARCINOMA- PREVENTION-OBSERVATION) as alternative. Disease anchors verified 2026-05-18: DIS-CHOLANGIOCARCINOMA exists as a KB entity. Anchored PSC primarily to DIS-CHOLANGIOCARCINOMA (per advisor recommendation). DIS-CRC included for PSC-IBD subgroup; DIS-HCC included for cirrhotic PSC HCC risk. Evidence base: - **PSC → cholangiocarcinoma:** lifetime risk ~10-15%; annual incidence ~0.5-1.5%/year (multiple population-based registry studies including Bergquist et al. Gastroenterology 2002, Boberg et al. Hepatology 2009). - **PSC → gallbladder cancer:** ~10-fold elevated relative risk; ~3-14% lifetime risk depending on cohort. Gallbladder polyp...

Де використовується

Indications

IND-IBD-CRC-PREVENTION-CHROMOENDOSCOPY - IND-IBD-CRC-PREVENTION-CHROMOENDOSCOPY
IND-PSC-CHOLANGIOCARCINOMA-PREVENTION-OBSERVATION - IND-PSC-CHOLANGIOCARCINOMA-PREVENTION-OBSERVATION
IND-PSC-CHOLANGIOCARCINOMA-PREVENTION-SURVEILLANCE - IND-PSC-CHOLANGIOCARCINOMA-PREVENTION-SURVEILLANCE