Yoshimura Dai, Fukasawa Mitsuharu, Yoda Yoshioki, Ohtaka Masahiko, Ooka Tadao, Takano Shinichi, Kawakami Satoshi, Fukasawa Yoshimitsu, Kuratomi Natsuhiko, Harai Shota, Shimamura Naruki, Hasegawa Hiroyuki, Imagawa Naoto, Suzuki Yuichiro, Yoshida Takashi, Kobayashi Shoji, Sato Mitsuaki, Yamaguchi Tatsuya, Maekawa Shinya, Enomoto Nobuyuki
Department of Gastroenterology, Faculty of Medicine, University of Yamanashi, Chuo 409-3898, Japan.
Department of Gastroenterology, Japan Community Health Care Organization Yamanashi Hospital, Kofu 400-0025, Japan.
Diagnostics (Basel). 2024 Mar 20;14(6):651. doi: 10.3390/diagnostics14060651.
This study aimed to develop and validate a simple scoring system to determine the high-risk group for pancreatic cancer (PC) in the asymptomatic general population. The scoring system was developed using data from PC cases and randomly selected non-PC cases undergoing annual medical checkups between 2008 and 2013. The performance of this score was validated for participants with medical checkups between 2014 and 2016. In the development set, 45 PC cases were diagnosed and 450 non-PC cases were identified. Multivariate analysis showed three changes in clinical data from 1 year before diagnosis as independent risk factors: ΔHbA1c ≥ 0.3%, ΔBMI ≤ -0.5, and ΔLDL ≤ -20 mg/dL. A simple scoring system, incorporating variables and abdominal ultrasound findings, was developed. In the validation set, 36 PC cases were diagnosed over a 3-year period from 32,877 participants. The AUROC curve of the scoring system was 0.925 (95%CI 0.877-0.973). The positive score of early-stage PC cases, including Stage 0 and I cases, was significantly higher than that of non-PC cases (80% vs. 6%, = 0.001). The simple scoring system effectively narrows down high-risk PC cases in the general population and provides a reasonable approach for early detection of PC.
本研究旨在开发并验证一种简单的评分系统，以确定无症状普通人群中胰腺癌（PC）的高危人群。该评分系统利用2008年至2013年间PC病例以及随机选取的接受年度体检的非PC病例的数据开发而成。该评分的性能在2014年至2016年间接受体检的参与者中得到验证。在开发组中，确诊了45例PC病例，识别出450例非PC病例。多变量分析显示，诊断前1年临床数据的3项变化为独立危险因素：糖化血红蛋白（HbA1c）变化值≥0.3%、体重指数（BMI）变化值≤ -0.5以及低密度脂蛋白（LDL）变化值≤ -20 mg/dL。开发了一种纳入变量和腹部超声检查结果的简单评分系统。在验证组中，从32,877名参与者中，在3年期间确诊了36例PC病例。该评分系统的受试者工作特征曲线下面积（AUROC）为0.925（95%置信区间0.877 - 0.973）。包括0期和I期病例在内的早期PC病例的阳性评分显著高于非PC病例（80%对6%，P = 0.001）。该简单评分系统有效地缩小了普通人群中PC高危病例的范围，并为PC的早期检测提供了一种合理的方法。
