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无症状初发糖尿病患者中糖类抗原19-9水平早期检查对胰腺癌筛查的价值

Value of Early Check-Up of Carbohydrate Antigen 19-9 Levels for Pancreatic Cancer Screening in Asymptomatic New-Onset Diabetic Patients.

作者信息

Choe Jung Wan, Kim Jae Seon, Kim Hyo Jung, Hwang Soon Young, Joo Moon Kyung, Lee Beom Jae, Kim Ji Hoon, Yeon Jong Eun, Park Jong-Jae, Byun Kwan Soo, Bak Young-Tae

机构信息

From the *Department of Internal Medicine and †Department of Biostatistics, Korea University college of Medicine Guro Hospital, Seoul, South Korea.

出版信息

Pancreas. 2016 May-Jun;45(5):730-4. doi: 10.1097/MPA.0000000000000538.

Abstract

OBJECTIVES

We evaluated the value of carbohydrate antigen 19-9 (CA 19-9) as a pancreatic cancer (PC) screening tool in an asymptomatic new-onset diabetic patients.

METHODS

Medical records of asymptomatic patients newly diagnosed with diabetes mellitus (DM) were reviewed retrospectively at our hospital from January 2004 to January 2013.

RESULTS

In total, 2363 asymptomatic diabetic patients with CA 19-9 measurements were enrolled. Of them, 68 (2.9%) were diagnosed with PC. In the 1719 patients who had CA 19-9 measured within 1 year after the DM diagnosis, a total of 51 (3.0 %) patients developed PC and the odds ratio (OR) of PC according to higher CA 19-9 than normal upper limit, 37 IU/mL was 5.57 (P < 0.001). In 248 patients checked CA 19-9 between 1 and 2 years after DM diagnosis, PC was detected in 9 (3.6%) cases and OR of high CA 19-9 was 4.51 (P = 0.019). However, beyond 2 years, the OR for PC showed no statistical significance. The patients with high CA 19-9 levels tended to have more advanced-stage disease.

CONCLUSIONS

Early check-up of CA 19-9 could be a useful marker for screening for PC in asymptomatic patients with new-onset DM in the first 2 years.

摘要

目的

我们评估了糖类抗原19-9(CA 19-9)作为无症状新发糖尿病患者胰腺癌(PC)筛查工具的价值。

方法

回顾性分析了我院2004年1月至2013年1月期间新诊断为糖尿病(DM)的无症状患者的病历。

结果

总共纳入了2363例检测了CA 19-9的无症状糖尿病患者。其中,68例(2.9%)被诊断为胰腺癌。在糖尿病诊断后1年内检测CA 19-9的1719例患者中,共有51例(3.0%)发生了胰腺癌,CA 19-9高于正常上限37 IU/mL时胰腺癌的比值比(OR)为5.57(P < 0.001)。在糖尿病诊断后1至2年检测CA 19-9的248例患者中,9例(3.6%)检测到胰腺癌,高CA 19-9的OR为4.51(P = 0.019)。然而,超过2年后,胰腺癌的OR无统计学意义。CA 19-9水平高的患者往往疾病分期更晚。

结论

在最初2年内,早期检测CA 19-9可能是无症状新发糖尿病患者胰腺癌筛查的有用标志物。

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