Baydogan Seyda, Mohindroo Chirayu, Hasanov Merve, Montiel Maria F, Quesada Pompeyo, Cazacu Irina M, Luzuriaga Chavez Adrianna A, Mork Maureen E, Dong Wenli, Feng Lei, You Y Nancy, Arun Banu, Vilar Eduardo, Brown Powel, Katz Matthew H G, Chari Suresh T, Maitra Anirban, Tamm Eric P, Kim Michael P, Bhutani Manoop S, McAllister Florencia
Departments of Clinical Cancer Prevention the University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Internal Medicine, Sinai Hospital of Baltimore, Baltimore, MD, USA.
Endosc Ultrasound. 2024 Mar-Apr;13(2):83-88. doi: 10.1097/eus.0000000000000057. Epub 2024 Apr 10.
Pancreatic cancer (PC) is the third cause of cancer-related deaths. Early detection and interception of premalignant pancreatic lesions represent a promising strategy to improve outcomes. We evaluated risk factors of focal pancreatic lesions (FPLs) in asymptomatic individuals at hereditary high risk for PC.
This is an observational single-institution cohort study conducted over a period of 5 years. Surveillance was performed through imaging studies (EUS or magnetic resonance imaging/magnetic resonance cholangiopancreatography) and serum biomarkers. We collected demographic characteristics and used univariate and multivariate logistic regression models to evaluate associations between potential risk factors and odd ratios (ORs) for FPL development.
A total of 205 patients completed baseline screening. Patients were followed up to 53 months. We detected FPL in 37 patients (18%) at baseline; 2 patients had lesions progression during follow-up period, 1 of them to PC. Furthermore, 13 patients developed new FPLs during the follow-up period. Univariate and multivariate analyses revealed that new-onset diabetes (NOD) is strongly associated with the presence of FPL (OR, 10.94 [95% confidence interval, 3.01-51.79; < 0.001]; OR, 9.98 [95% confidence interval, 2.15-46.33; = 0.003]). Follow-up data analysis revealed that NOD is also predictive of lesions progression or development of new lesions during screening (26.7% 2.6%; = 0.005).
In a PC high-risk cohort, NOD is significantly associated with presence of FPL at baseline and predictive of lesions progression or new lesions during surveillance.
胰腺癌（PC）是癌症相关死亡的第三大原因。早期检测和拦截癌前胰腺病变是改善预后的一种有前景的策略。我们评估了遗传性PC高危无症状个体中局灶性胰腺病变（FPLs）的危险因素。
这是一项在单一机构进行的为期5年的观察性队列研究。通过影像学检查（超声内镜或磁共振成像/磁共振胰胆管造影）和血清生物标志物进行监测。我们收集了人口统计学特征，并使用单变量和多变量逻辑回归模型来评估潜在危险因素与FPL发生的比值比（OR）之间的关联。
共有205例患者完成了基线筛查。患者随访至53个月。我们在基线时检测到37例（18%）患者有FPL；2例患者在随访期间病变进展，其中1例进展为PC。此外，13例患者在随访期间出现了新的FPL。单变量和多变量分析显示，新发糖尿病（NOD）与FPL的存在密切相关（OR，10.94[95%置信区间，3.01 - 51.79；P<0.001]；OR，9.98[95%置信区间，2.15 - 46.33；P = 0.003]）。随访数据分析显示，NOD也可预测筛查期间病变进展或新病变的发生（26.7%对2.6%；P = 0.005）。
在PC高危队列中，NOD与基线时FPL的存在显著相关，并可预测监测期间病变进展或新病变的发生。
