糖尿病对胰腺癌结局的影响。
Impact of diabetes mellitus on the outcome of pancreatic cancer.
机构信息
Department of Internal Medicine, Division of Hematology/Oncology, University of Texas Southwestern Medical Center, Dallas, Texas, United States of America.
Division of Biostatistics and Epidemiology, Department of Biomedical Sciences, Texas Tech University Health Sciences Center, El Paso, Texas, United States of America.
出版信息
PLoS One. 2014 May 30;9(5):e98511. doi: 10.1371/journal.pone.0098511. eCollection 2014.
INTRODUCTION
Diabetes mellitus (DM) has the potential to impact the pathogenesis, treatment, and outcome of pancreatic cancer. This study evaluates the impact of DM on pancreatic cancer survival.
METHODS
We conducted a retrospective cohort study from the Veterans Affairs (VA) Central Cancer Registry (VACCR) for pancreatic cancer cases between 1995 and 2008. DM and no-DM cases were identified from comorbidity data. Univariate and multivariable analysis was performed. Multiple imputation method was employed to account for missing variables.
RESULTS
Of 8,466 cases of pancreatic cancer DM status was known in 4728 cases that comprised this analysis. Males accounted for 97.7% cases, and 78% were white. Overall survival was 4.2 months in DM group and 3.6 months in the no-DM group. In multivariable analysis, DM had a HR = 0.91 (0.849-0.974). This finding persisted after accounting for missing variables using multiple imputations method with the HR in DM group of 0.93 (0.867-0.997).
CONCLUSIONS
Our data suggest DM is associated with a reduction in risk of death in pancreatic cancer. Future studies should be directed towards examining this association, specifically impact of DM medications on cancer outcome.
简介
糖尿病（DM）有可能影响胰腺癌的发病机制、治疗和结果。本研究评估了 DM 对胰腺癌生存的影响。
方法
我们对退伍军人事务部（VA）中央癌症登记处（VACCR） 1995 年至 2008 年间的胰腺癌病例进行了回顾性队列研究。从合并症数据中确定了 DM 和非 DM 病例。进行了单变量和多变量分析。采用多重插补法处理缺失变量。
结果
在 8466 例胰腺癌病例中，4728 例已知 DM 状态，包括本分析。男性占 97.7%，78%为白人。DM 组的总生存率为 4.2 个月，非 DM 组为 3.6 个月。在多变量分析中，DM 的 HR = 0.91（0.849-0.974）。在使用多重插补法处理缺失变量后，这一发现仍然存在，DM 组的 HR 为 0.93（0.867-0.997）。
结论
我们的数据表明，DM 与胰腺癌死亡风险降低相关。未来的研究应针对检查这种关联，特别是 DM 药物对癌症结果的影响。
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