Popovic Katarina, Smolović Brigita, Martinović Milica, Vučković Ljiljana
Faculty of Medicine, University of Montenegro, Podgorica, Montenegro.
Department of Gastroenterology, Clinical Center of Montenegro, Podgorica, Montenegro.
Cancer Epidemiol Biomarkers Prev. 2023 Mar 6;32(3):298-305. doi: 10.1158/1055-9965.EPI-22-0951.
The relationship between diabetes mellitus (DM) and pancreatic cancer is complex-DM is both a risk factor and early sign of pancreatic cancer. DM is a risk factor for pancreatic cancer because it increases insulin resistance, intrapancreatic concentrations of insulin, and the bioavailability of IGF, subsequently promoting ductal cell proliferation. Accordingly, treatment targeting the insulin/IGF pathway is the focus of many researchers. Antidiabetic drugs modify the risk for pancreatic cancer-metformin's antineoplastic effect being most notable and indicating potential clinical use in pancreatic cancer. New-onset DM can also be the first manifestation of pancreatic cancer. There are several theories for the pathogenesis of DM in pancreatic cancer, the most important being that DM is a paraneoplastic syndrome caused by diabetogenic factors. As a consequence of this intricate relationship, new-onset DM after the age of 50 is considered a red flag for pancreatic cancer, prompting the need for screening in this patient population. Multiple clinical studies are currently underway exploring this matter. A better understanding of the relationship between DM and pancreatic cancer could aid in developing novel screening and treatment strategies for pancreatic cancer. This could ultimately improve the prognosis and quality of life of patients with pancreatic cancer.
糖尿病（DM）与胰腺癌之间的关系错综复杂——DM既是胰腺癌的危险因素，也是其早期迹象。DM是胰腺癌的危险因素，因为它会增加胰岛素抵抗、胰腺内胰岛素浓度以及胰岛素样生长因子（IGF）的生物利用度，进而促进导管细胞增殖。因此，针对胰岛素/IGF通路的治疗是许多研究人员关注的焦点。抗糖尿病药物可改变患胰腺癌的风险——二甲双胍的抗肿瘤作用最为显著，显示出在胰腺癌治疗中的潜在临床应用价值。新发DM也可能是胰腺癌的首发表现。关于胰腺癌中DM的发病机制有多种理论，其中最重要的是DM是由致糖尿病因素引起的副肿瘤综合征。由于这种复杂的关系，50岁后新发DM被视为胰腺癌的警示信号，促使对该患者群体进行筛查。目前正在进行多项临床研究探索此事。更好地理解DM与胰腺癌之间的关系有助于开发胰腺癌的新型筛查和治疗策略。这最终可能改善胰腺癌患者的预后和生活质量。
