胰酶替代疗法在不可切除胰腺癌中的作用：一项前瞻性队列研究。

The Role of Pancreatic Enzyme Replacement Therapy in Unresectable Pancreatic Cancer: A Prospective Cohort Study.

作者信息

Saito Tomotaka, Hirano Kenji, Isayama Hiroyuki, Nakai Yousuke, Saito Kei, Umefune Gyotane, Akiyama Dai, Watanabe Takeo, Takagi Kaoru, Hamada Tsuyoshi, Takahara Naminatsu, Uchino Rie, Mizuno Suguru, Kogure Hirofumi, Matsubara Saburo, Yamamoto Natsuyo, Tada Minoru, Koike Kazuhiko

机构信息

From the *Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo; and †Department of Gastroenterology, Tokyo Takanawa Hospital, Tokyo, Japan.

出版信息

Pancreas. 2017 Mar;46(3):341-346. doi: 10.1097/MPA.0000000000000767.

DOI:10.1097/MPA.0000000000000767

PMID:28099252

Abstract

OBJECTIVES

Although patients with pancreatic cancer (PC) are prone to exocrine pancreatic insufficiency, there are little evidence about pancreatic enzyme replacement therapy (PERT) in patients with PC, especially those receiving chemotherapy.

METHODS

This is a prospective consecutive observational study of PERT in patients with unresectable PC. We prospectively enrolled patients receiving chemotherapy for unresectable PC from April 2012 to February 2014 and prescribed oral pancrelipase of 48,000 lipase units per meal (pancrelipase group). N-benzoyl-tryrosyl para-aminobenzoic acid test was performed at baseline. Patients receiving chemotherapy before April 2012 were retrospectively studied as a historical cohort. Data on the nutritional markers at baseline and 16 weeks were extracted, and serial changes, defined as the ratio of markers at 16 weeks/baseline, were compared between 2 groups.

RESULTS

A total of 91 patients (46 in the pancrelipase group and 45 in the historical cohort) were analyzed. N-benzoyl-tryrosyl para-aminobenzoic acid test was low in 94% of the pancrelipase group. Serial change in the pancrelipase group versus historical cohort was 1.01 versus 0.95 in body mass index (P < 0.001) and 1.03 versus 0.97 in serum albumin (P = 0.131).

CONCLUSIONS

The rate of exocrine pancreatic insufficiency in unresectable PC was high, and PERT can potentially improve the nutritional status during chemotherapy.

摘要

目的

尽管胰腺癌（PC）患者易出现外分泌性胰腺功能不全，但关于PC患者，尤其是接受化疗的患者的胰酶替代疗法（PERT）的证据很少。

方法

这是一项针对不可切除PC患者的PERT前瞻性连续观察研究。我们前瞻性纳入了2012年4月至2014年2月期间因不可切除PC接受化疗的患者，并每餐开具48,000脂肪酶单位的口服胰酶（胰酶组）。在基线时进行了N-苯甲酰-酪氨酰对氨基苯甲酸试验。对2012年4月之前接受化疗的患者进行回顾性研究作为历史队列。提取基线和16周时的营养标志物数据，并比较两组之间定义为16周时标志物与基线时标志物之比的系列变化。