Department of Digestive Diseases and Internal Medicine, Sant'Orsola-Malpighi Hospital, 40138 Bologna, Italy.
World J Gastroenterol. 2013 Aug 14;19(30):4861-6. doi: 10.3748/wjg.v19.i30.4861.
The relationship between diabetes mellitus and the risk of pancreatic cancer has been a matter of study for a long period of time. The importance of this topic is due to two main causes: the possible use of recent onset diabetes as a marker of the disease and, in particular, as a specific marker of pancreatic cancer, and the selection of a population at risk for pancreatic cancer. Thus, we decided to make an in-depth study of this topic; thus, we carried out an extensive literature search in order to re-assess the current knowledge on this topic. Even if diabetes is found a decade before the appearance of pancreatic cancer as reported in meta-analytic studies, we cannot select those patients already having non detectable pancreatic cancer, at least with the imaging and biological techniques available today. We believe that more studies are necessary in order to definitively identify diabetes mellitus as a risk factor for pancreatic cancer taking into consideration that approximately 10 years are needed to diagnose symptomatic pancreatic cancer. At present, the answer to the as to whether diabetes and pancreatic cancer comes first similar to the adage of the chicken and the egg is that diabetes is the egg.
糖尿病与胰腺癌风险之间的关系一直是一个长期的研究课题。这个话题之所以重要,有两个主要原因:一是新发糖尿病可能作为疾病的标志物,尤其是作为胰腺癌的特定标志物;二是选择胰腺癌高危人群。因此,我们决定深入研究这个课题;为此,我们进行了广泛的文献检索,以重新评估当前对这个课题的认识。即使在荟萃分析研究中报告了糖尿病在胰腺癌出现前 10 年就已经存在,但我们无法选择那些已经患有无法检测到的胰腺癌的患者,至少使用目前现有的成像和生物学技术无法做到。我们认为,需要进行更多的研究,以便明确将糖尿病确定为胰腺癌的危险因素,因为诊断有症状的胰腺癌大约需要 10 年的时间。目前,糖尿病和胰腺癌哪个是因哪个是果的问题与“先有鸡还是先有蛋”这句谚语类似,糖尿病是因。