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高血糖预示晚期胰腺癌患者预后不良。

Hyperglycemia predicts adverse prognosis in advanced pancreatic cancer patients.

作者信息

Zhu Xinzhe, Xu Huaxiang, Xiao Zhiwen, Liu He, Ni Quanxing, Yu Xianjun, Luo Guopei

机构信息

Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.

Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.

出版信息

Endocrine. 2023 Feb;79(2):296-303. doi: 10.1007/s12020-022-03196-4. Epub 2023 Jan 7.

Abstract

BACKGROUND

Diabetes mellitus is a prevalent comorbidity in pancreatic cancer. Previous studies have mainly concentrated on the association between diabetes and pancreatic cancer outcomes. However, research on the impact of hyperglycemia on the prognosis of patients with advanced pancreatic cancer is limited.

METHODS

Information on patients with advanced pancreatic cancer was collected from a prospectively maintained database, and the patients were divided into the hyperglycemia group (fasting blood glucose ≥7.0 mmol/L) and the normoglycemia group (fasting blood glucose < 7.0 mmol/L). Patients with preexisting diabetes were not included in these groups. The associations between hyperglycemia and clinical variables or prognosis were analyzed.

RESULTS

Among 697 patients with advanced pancreatic cancer and no prior history of diabetes, 25.3% were diagnosed with hyperglycemia. Patients older than 65 years had a higher risk of developing hyperglycemia (P = 0.044). Patients with hyperglycemia had a worse prognosis than those with normoglycemia (median survival, 7.5 vs. 8.8 months, P < 0.001). Hyperglycemia was associated with increased mortality (hazard ratio = 1.38; P = 0.003).

CONCLUSIONS

Hyperglycemia predicts worse overall survival in patients with advanced pancreatic cancer.

摘要

背景

糖尿病是胰腺癌中一种常见的合并症。既往研究主要集中于糖尿病与胰腺癌预后之间的关联。然而,关于高血糖对晚期胰腺癌患者预后影响的研究有限。

方法

从一个前瞻性维护的数据库中收集晚期胰腺癌患者的信息,并将患者分为高血糖组(空腹血糖≥7.0 mmol/L)和正常血糖组(空腹血糖<7.0 mmol/L)。既往有糖尿病的患者不纳入这些组。分析高血糖与临床变量或预后之间的关联。

结果

在697例无糖尿病既往史的晚期胰腺癌患者中,25.3%被诊断为高血糖。65岁以上的患者发生高血糖的风险更高(P = 0.044)。高血糖患者的预后比正常血糖患者差(中位生存期,7.5个月对8.8个月,P < 0.001)。高血糖与死亡率增加相关(风险比 = 1.38;P = 0.003)。

结论

高血糖预示晚期胰腺癌患者的总生存期较差。

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