Clinical characteristics of patients with pancreatic cancer combined with new onset diabetes mellitus
10.3969/j.issn.1001-5256.2022.12.018
- VernacularTitle:胰腺癌合并新发糖尿病患者的临床特征分析
- Author:
Qian ZHAO
1
;
Yongliang FENG
1
;
Yan WANG
2
;
Zhigang WEI
2
Author Information
1. School of Public Health, Shanxi Medical University, Taiyuan 030001, China
2. Hepatobiliary and Pancreatic Surgery and Liver Transplantation Center, First Hospital of Shanxi Medical University, Taiyuan 030001, China
- Publication Type:Original Articles_Pancreatic Diseases
- Keywords:
Pancreatic Neoplasms;
Diabetes Mellitus;
Pathology, Clinical
- From:
Journal of Clinical Hepatology
2022;38(12):2780-2786
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical characteristics of patients with pancreatic cancer (PC) complicated with new-onset diabetes mellitus (DM), and to provide a basis for defining a high-risk group for PC. Methods The 426 PC cases admitted to the First Hospital of Shanxi Medical University from January 2016 to December 2021 were retrospectively selected and divided into new DM group (disease duration ≤2 years, n =74), long-term DM group (disease duration > 2 years, n =50) and simple PC group (no DM, n =302). We collected their basic demographic information, smoking and drinking history, disease history, family history, DM medication, clinical characteristics (first symptoms, tumor diameter, mass location, pancreatic duct dilatation, surgical resection) and biochemical indexes (FPG, CA19-9, CA125). The glycemic status of those who underwent surgical resection was monitored for six months after surgery. The t -test was used for comparison of normally distributed continuous data between two groups, and the Wilcoxon rank-sum test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test and the Fisher's exact test were used for comparison of categorical data between two groups. Results Of the 426 PC patients, 68.3% were male and 31.7% were female. New-onset DM accounted for 59.7% of the PC patients with DM. Compared with the long-term DM group, the new-onset DM group had a lower age of onset ( t =-2.041, P =0.043), a lower proportion of combined hypertension ( χ 2 =3.950, P =0.047), a lower family history of DM ( χ 2 =3.893, P =0.048), a lower FPG level ( Z =-2.740, P =0.005), a higher proportion of smokers ( χ 2 =7.032, P =0.008), significant weight change ( Z =-2.161, P =0.031), larger tumor diameter ( Z =-2.269 P =0.023), high proportion of those with pancreatic duct dilatation ( χ 2 =4.870, P =0.027), and significant differences in DM medication ( χ 2 =1.976, P < 0.05). At six months of follow-up, 7 patients (36.8%) in the new-onset DM surgery group had glycemic improvement, but none in the long-term DM surgery group. Compared with the PC-only group, the new-onset DM group had a lower age of onset ( t =-0.273, P =0.039), a slightly higher BMI level ( t =-2.139, P =0.033), a significant weight change ( Z =-2.262, P =0.024), a higher proportion of complicated hypertension ( χ 2 =17.438, P < 0.001), a higher FPG level ( Z =-8.322, P < 0.001), and a high proportion of dilated pancreatic ducts ( χ 2 =3.983, P =0.046). Conclusion Among PC patients, the onset age is relatively young in those complicated with new-onset DM. Patients with new-onset DM who smoke, have no family history of DM, have significant weight loss, have difficulty in controlling FPG levels, and pancreatic duct dilatation may be at high-risk for PC and should be screened early.
