Jeon Christie Y, Li Donghui, Cleary Sean, Stolzenberg-Solomon Rachael, Bosetti Cristina, La Vecchia Carlo, Porta Miquel, Toriola Adetunji T, Hung Rayjean J, Kurtz Robert C, Olson Sara H
Pancreas. 2018 Mar;47(3):314-320. doi: 10.1097/MPA.0000000000000989.
It is unclear whether long-standing diabetes or new-onset pancreatogenic diabetes contributes to poor prognosis in patients with pancreatic ductal adenocarcinoma (PDAC).
We investigated the influence of diabetes diagnosed shortly before PDAC and long-term diabetes on overall survival in 2792 PDAC patients who had participated in 3 PDAC case-control studies in the Pancreatic Cancer Case-Control Consortium. There were 300 patients with long-term diabetes of more than 3 years' duration (11%) and 418 patients with recently diagnosed diabetes of 3-year duration or less (15%). We performed Cox regression to determine the association of long-term diabetes and recently diagnosed diabetes with overall survival, adjusting for study site, age, sex, race, stage of disease, surgery, chemotherapy, smoking history, and body mass index at diagnosis.
In the overall population, neither long-term diabetes (hazard ratio [HR], 1.10; 95% confidence interval [CI], 0.97-1.26) nor recently diagnosed diabetes (HR, 1.06; 95% CI, 0.94-1.18) was associated with shorter survival. When stratified by stage of disease, long-term diabetes was associated with 42% increase in rate of death in persons with resectable PDAC (HR, 1.42; 95% CI, 1.13-1.78), whereas it was not associated with survival in PDAC patients with more advanced disease.
Long-term diabetes was associated with increased rate of death in patients with resectable PDAC.
目前尚不清楚长期糖尿病或新发胰腺源性糖尿病是否会导致胰腺导管腺癌（PDAC）患者预后不良。
我们调查了在胰腺癌病例对照联盟中参与3项PDAC病例对照研究的2792例PDAC患者中，PDAC确诊前不久诊断的糖尿病和长期糖尿病对总生存期的影响。有300例长期糖尿病患者，病程超过3年（11%），418例近期诊断的糖尿病患者，病程为3年或更短（15%）。我们进行了Cox回归分析，以确定长期糖尿病和近期诊断的糖尿病与总生存期之间的关联，并对研究地点、年龄、性别、种族、疾病分期、手术、化疗、吸烟史和诊断时的体重指数进行了校正。
在总体人群中，长期糖尿病（风险比[HR]，1.10；95%置信区间[CI]，0.97-1.26）和近期诊断的糖尿病（HR，1.06；95%CI，0.94-1.18）均与生存期缩短无关。按疾病分期分层时，长期糖尿病与可切除性PDAC患者的死亡率增加42%相关（HR，1.42；95%CI，1.13-1.78），而在疾病更晚期的PDAC患者中，长期糖尿病与生存期无关。
长期糖尿病与可切除性PDAC患者的死亡率增加相关。
