Santos Ana P, Rodrigues Jessica, Henrique Rui, Cardoso M Helena, Monteiro Mariana P
Department of Endocrinology, Portuguese Oncology Institute of Porto (IPO Porto), Porto Comprehensive Cancer Centre (P.CCC), 4200-072 Porto, Portugal.
Precancerous Lesions and Early Cancer Management Group, Research Center of IPO Porto (CI-IPOP), RISE@CI-IPO (Health Research Network), Portuguese Oncology Institute of Porto (IPO Porto), Porto Comprehensive Cancer Centre (P.CCC), 4200-072 Porto, Portugal.
J Clin Med. 2022 Oct 12;11(20):6026. doi: 10.3390/jcm11206026.
The association of well-differentiated gastro-entero-pancreatic neuroendocrine neoplasia (WD GEP-NEN) with metabolic syndrome (MetS), abdominal obesity, and fasting glucose abnormalities was recently described. However, whether obesity and metabolic syndrome risk factors are associated with GEP-NEN adverse outcomes and the poorer prognosis was unknown. The present study aimed to evaluate whether the presence of MetS or any of its individual components at WD GEP-NEN diagnosis influenced disease outcomes. A cohort of patients with non-localized WD GEP-NETs ( = 81), was classified according to the primary tumor site (gastrointestinal or pancreatic), pathological grading (G1 (Ki67 ≤ 2%) and G2 (3% ≤ Ki67 ≤ 20%) (WHO 2010)), disease extension (loco-regional or metastatic disease), presence of hormonal secretion syndrome (functioning or non-functioning), and evaluated for the presence of MetS criteria at diagnosis. MetS was present in 48 (59.3%) patients. During a median follow-up of 95.0 months (16.8-262.5), 18 patients died of the disease (10 with MetS vs. 8 without MetS). Overall survival (OS) at 5 years was 87.1% (95% CI: 73.6-94.0) for MetS and 90.9% (95% CI: 74.4-97.0) for non-Mets group, while OS at 10 years was 72.5% (95% CI: 55.3-84.0) for MetS, and 76.4% (95% CI: 53.6-89.0) for non-MetS group. Progression-Free Survival (PFS) at 5 years was 45.9% (95% CI: 30.8-59.8) for MetS and 40.0% (95% CI: 21.3-58.1) for non-MetS group, and PFS at 10 years was 18.1% (95% CI: 7.0-33.5) for MetS and 24.4% (95% CI: 9.0-43.7) for non-MetS group. Waist circumference (WC), a surrogate measure for visceral obesity, was associated with significantly shorter PFS (HR = 1.03; 95% CI: 1.01-1.06), although did not influence OS (HR = 1.01; 95% CI: 0.97-1.06). The findings of this study reinforce a potential link between visceral obesity and GEP-NEN and further suggest that obesity could influence disease prognosis.
最近有研究描述了高分化胃肠胰神经内分泌肿瘤（WD GEP-NEN）与代谢综合征（MetS）、腹型肥胖及空腹血糖异常之间的关联。然而，肥胖和代谢综合征风险因素是否与GEP-NEN的不良结局及较差预后相关尚不清楚。本研究旨在评估WD GEP-NEN诊断时MetS或其任何单个组分的存在是否会影响疾病结局。对一组非局限性WD GEP-NETs患者（n = 81），根据原发肿瘤部位（胃肠道或胰腺）、病理分级（G1（Ki67≤2%）和G2（3%≤Ki67≤20%）（WHO 2010））、疾病分期（局部区域或转移性疾病）、激素分泌综合征的存在情况（功能性或非功能性）进行分类，并评估诊断时MetS标准的存在情况。48例（59.3%）患者存在MetS。在中位随访95.0个月（16.8 - 262.5）期间，18例患者死于该疾病（10例有MetS，8例无MetS）。MetS组5年总生存率（OS）为87.1%（95%CI：73.6 - 94.0），非MetS组为90.9%（95%CI：74.4 - 97.0），而MetS组10年OS为72.5%（95%CI：55.3 - 84.0），非MetS组为76.4%（95%CI：53.6 - 89.0）。MetS组5年无进展生存期（PFS）为45.9%（95%CI：30.8 - 59.8），非MetS组为40.0%（95%CI：21.3 - 58.1），MetS组10年PFS为18.1%（95%CI：7.0 - 33.5），非MetS组为24.4%（95%CI：9.0 - 43.7）。腰围（WC）作为内脏肥胖的替代指标，与显著缩短的PFS相关（HR = 1.03；95%CI：1.01 - 1.06），尽管对OS无影响（HR = 1.01；95%CI：0.97 - 1.06）。本研究结果强化了内脏肥胖与GEP-NEN之间的潜在联系，并进一步表明肥胖可能影响疾病预后。
