非侵入性模型筛查新发糖尿病患者中早期胰腺癌低风险人群。

Noninvasive Models Screen New-Onset Diabetics at Low Risk of Early-Onset Pancreatic Cancer.

机构信息

From the Section of General Internal Medicine.

Section of Gastroenterology and Hepatology, Department of Medicine, West Virginia University School of Medicine, Morgantown, WV.

出版信息

Pancreas. 2021 Oct 1;50(9):1326-1330. doi: 10.1097/MPA.0000000000001917.

DOI:10.1097/MPA.0000000000001917

PMID:34860819

Abstract

OBJECTIVES

Several noninvasive models have been developed to identify new-onset diabetics at higher risk of developing pancreatic ductal adenocarcinoma (PDAC). However, they need external validation before implementation.

METHODS

This study validated one such model (Boursi model) among a cohort of new-onset diabetics. A bivariate analysis of the model's components was done between patients who developed PDAC and type 2 diabetics. The model performance was assessed through receiver-operative characteristic curve analysis.

RESULTS

Patients with PDAC had significantly lower total cholesterol and alkaline phosphatase at diagnosis of diabetes (P < 0.01). They were observed losing body mass index (BMI) preceding diagnosis (ΔBMI = -0.42 kg/m2, P < 0.01). The model's area under the curve was 0.83 (95% confidence interval, 0.79-0.88). The cutoff that maximized the Youden index was at 0.8%. At this cutoff, the sensitivity was 75%, specificity was 80%, and the prevalence of pancreatic cancer increased from 0.19% at baseline to 0.69%.

CONCLUSIONS

Boursi model enriches the prevalence of PDAC among new-onset diabetics.

摘要

目的

已经开发出几种非侵入性模型来识别新诊断的糖尿病患者中发生胰腺导管腺癌 (PDAC) 的风险更高的患者。然而，在实施之前，它们需要外部验证。

方法

本研究在新诊断的糖尿病患者队列中验证了这样一种模型（Boursi 模型）。对发生 PDAC 的患者和 2 型糖尿病患者之间模型组成部分进行双变量分析。通过接收者操作特征曲线分析评估模型性能。

结果

PDAC 患者在诊断糖尿病时总胆固醇和碱性磷酸酶明显较低（P < 0.01）。他们被观察到在诊断前体重指数（BMI）下降（ΔBMI = -0.42 kg/m2，P < 0.01）。该模型的曲线下面积为 0.83（95%置信区间，0.79-0.88）。最大化约登指数的截止值为 0.8%。在此截止值下，灵敏度为 75%，特异性为 80%，并且胰腺癌的患病率从基线时的 0.19%增加到 0.69%。