Bunduc Ștefania, Iacob Răzvan, Costache Roxana, Stoica Bianca, Radu Cristina, Gheorghe Cristian
Chirurgia (Bucur). 2018 May-Jun;113(3):405-411. doi: 10.21614/chirurgia.113.3.405.
Pancreatic cancer (PC) is usually diagnosed in the 7th decade, but cases diagnosed in younger patients are associated with a greater disease burden, through the potential years of life lost. The aim of our study was to compare the differences in risk factors, clinical presentation and treatment options between patients diagnosed with pancreatic adenocarcinoma below 45 years of age (very early onset pancreatic adenocarcinoma - VEOPC), and those diagnosed over 45 years. A retrospective study has been conducted by registering in standardized Excel Worksheets all PC cases diagnosed in our tertiary referral center between 01.01.2015 and 31.12.2017. Only patients with a documented diagnosis of pancreatic adenocarcinoma (PDAC) were included in the statistical analysis that has been conducted using the NCSS v9 Statistical Software package. Categorical data have been compared using Chi2 test or Fisher Exact as appropriate, with a statistical significance p value 0.05. There were 296 patients diagnosed with pancreatic solid tumors during the study period, 183 cases with documented histology: 80.87% PDAC, 17.5% neuroendocrine tumors, 2 cases of LMNH and 1 MANEC tumor. In our study group there were 24 patients (16.22%) with VEOPC. Family history of pancreatic neoplasia (33.3% vs 1.03%, p=0.0004) and alcohol consumption (42.86% vs 5.41%, p=0.01) were significantly more prevalent in young patients. Pain, as primary symptom, was reported at higher rates in patients with VEOPC (60% vs 22.94%, p=0.006). Tumors were more frequently located in the head of the pancreas in younger patients (56.52%) and in the body of the pancreas in older patients (52.07%, p=0.02). There was no significant difference in therapy or death rate during follow-up period between the two study groups, although patients diagnosed under 45 years were more frequently subjected to a radical resection (33.3% vs 22.69%). Our study has identified alcohol consumption and family history of pancreatic neoplasia as risk factors for VEOPC. Pain is the primary symptom at diagnosis in young patients with PDAC. In our cohort, therapeutic options do not differ significantly in PDAC patients with age of onset.
胰腺癌（PC）通常在70岁左右被诊断出来，但在年轻患者中诊断出的病例，由于潜在的生命年损失，与更大的疾病负担相关。我们研究的目的是比较45岁以下被诊断为胰腺腺癌的患者（极早期发病胰腺腺癌 - VEOPC）与45岁以上被诊断患者在危险因素、临床表现和治疗选择上的差异。通过在标准化Excel工作表中记录2015年1月1日至2017年12月31日期间在我们的三级转诊中心诊断出的所有PC病例，进行了一项回顾性研究。只有记录有胰腺腺癌（PDAC）诊断的患者才被纳入使用NCSS v9统计软件包进行的统计分析。分类数据已根据情况使用卡方检验或Fisher精确检验进行比较，统计学显著性p值为0.05。在研究期间有296例被诊断为胰腺实性肿瘤的患者，183例有记录的组织学病例：80.87%为PDAC，17.5%为神经内分泌肿瘤，2例为低级别黏液性非肿瘤性病变和1例混合性神经内分泌-非神经内分泌肿瘤。在我们的研究组中有24例（16.22%）VEOPC患者。胰腺肿瘤家族史（33.3%对1.03%，p = 0.0004）和饮酒（42.86%对5.41%，p = 0.01）在年轻患者中明显更普遍。作为主要症状，疼痛在VEOPC患者中的报告率更高（60%对22.94%，p = 0.006））。肿瘤在年轻患者中更频繁地位于胰头（56.52%），而在老年患者中更常位于胰体（52.07%，p = 0.02）。在随访期间，两个研究组在治疗或死亡率方面没有显著差异，尽管45岁以下诊断出的患者更频繁地接受根治性切除术（33.3%对22.69%）。我们的研究已确定饮酒和胰腺肿瘤家族史是VEOPC的危险因素。疼痛是年轻PDAC患者诊断时的主要症状。在我们的队列中，不同发病年龄的PDAC患者的治疗选择没有显著差异。
