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过敏、肥胖、其他风险因素与胰腺癌的生存。

Allergies, obesity, other risk factors and survival from pancreatic cancer.

机构信息

Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA.

出版信息

Int J Cancer. 2010 Nov 15;127(10):2412-9. doi: 10.1002/ijc.25240.

Abstract

Survival from pancreatic adenocarcinoma remains extremely poor, approximately 5% at 5 years. Risk factors include smoking, high body mass index (BMI), family history of pancreatic cancer, and long-standing diabetes; in contrast, allergies are associated with reduced risk. Little is known about associations between these factors and survival. We analyzed overall survival in relation to risk factors for 475 incident cases who took part in a hospital based case-control study. Analyses were conducted separately for those who did (160) and did not (315) undergo tumor resection. Kaplan-Meier methods were used to describe survival according to smoking, BMI, family history, diabetes, and presence of allergies. Cox proportional hazards models were used to adjust for covariates. There was no association with survival based on smoking, family history, or history of diabetes in either group. Among patients with resection, those with allergies showed nonstatistically significant longer survival, a median of 33.1 months (95% CI: 19.0-52.5) vs. 21.8 months (95% CI: 18.0-33.1), p = 0.25. The adjusted hazard ratio (HR) was 0.72 (95% CI: 0.43-1.23), p = 0.23. Among patients without resection, those with self-reported allergies survived significantly longer than those without allergies: 13.3 months (95% CI: 10.6-16.9) compared to 10.4 months (95% CI: 8.8-11.0), p = 0.04, with an adjusted HR of 0.68 (95% CI: 0.49-0.95), p = 0.02. Obesity was nonsignificantly associated with poorer survival, particularly in the resected group (HR = 1.62, 95% CI: 0.76-3.44). The mechanisms underlying the association between history of allergies and improved survival are unknown. These novel results need to be confirmed in other studies.

摘要

胰腺腺癌的生存仍然非常差,大约 5 年生存率为 5%。危险因素包括吸烟、高体重指数(BMI)、家族胰腺癌史和长期糖尿病;相反,过敏与降低的风险相关。关于这些因素与生存的关系知之甚少。我们分析了与 475 例参加基于医院的病例对照研究的病例相关的总体生存与危险因素之间的关系。对于那些进行(160 例)和未进行(315 例)肿瘤切除术的患者分别进行分析。使用 Kaplan-Meier 方法根据吸烟、BMI、家族史、糖尿病和过敏的存在描述生存情况。使用 Cox 比例风险模型调整协变量。在两组患者中,吸烟、家族史或糖尿病史与生存均无关联。在接受切除术的患者中,过敏患者的生存时间明显更长,但无统计学意义,中位生存时间为 33.1 个月(95%CI:19.0-52.5)与 21.8 个月(95%CI:18.0-33.1)相比,p=0.25。调整后的风险比(HR)为 0.72(95%CI:0.43-1.23),p=0.23。在未接受切除术的患者中,自我报告过敏的患者比无过敏的患者存活时间明显更长:13.3 个月(95%CI:10.6-16.9)与 10.4 个月(95%CI:8.8-11.0)相比,p=0.04,调整后的 HR 为 0.68(95%CI:0.49-0.95),p=0.02。肥胖与较差的生存呈显著负相关,尤其是在接受切除术的患者中(HR=1.62,95%CI:0.76-3.44)。过敏史与生存改善之间关联的机制尚不清楚。这些新结果需要在其他研究中得到证实。

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