JCO:糖尿病可使胰腺癌患者生存期降低

2015-01-06 MedSci MedSci原创

目的:长期存在的糖尿病是罹患胰腺癌的一个危险因素,而在确诊胰腺癌之前的几年发现的糖尿病其实是胰腺癌的一个亚临床症状。然而,糖尿病对胰腺癌患者的生存影响却不为人们所知。 方法和材料:我们通过来自两个前瞻性研究队伍(护士健康研究(NHS)和健康专业人士随访研究(HPFS))里的从1986年至2010年诊断为糖尿病的1006名患者的糖尿病状态来分析其患有胰腺后的生存影响。我们在基于Dana-Farbe

目的:长期存在的糖尿病是罹患胰腺癌的一个危险因素,而在确诊胰腺癌之前的几年发现的糖尿病其实是胰腺癌的一个亚临床症状。然而,糖尿病对胰腺癌患者的生存影响却不为人们所知。

方法和材料:我们通过来自两个前瞻性研究队伍(护士健康研究(NHS)和健康专业人士随访研究(HPFS))里的从1986年至2010年诊断为糖尿病的1006名患者的糖尿病状态来分析其患有胰腺后的生存影响。我们在基于Dana-Farber癌症研究所(DFCI)的一系列临床案例报道中的386名从2004至2013年诊断糖尿病的胰腺癌患者中验证了我们的结论。我们采用Cox比例风险模型,并调整了年龄、性别、种族、吸烟、诊断时间、肿瘤分期,来估计死亡风险比。

结果:在NHS和HPFS组,相对于未患糖尿病的胰腺癌患者,长期患有糖尿病的患者其死亡风险比为1.40(95%CI,1.15-1.69),患有糖尿病的胰腺癌患者中位生存期为3个月,未患糖尿病的胰腺癌患者为5个月。调整了偏好评分以减低并存症带来的偏倚并未改变这个结果。在DFCI病例中,长期患有糖尿病的患者其死亡风险比为1.53(95%CI,1.07-2.20),患有糖尿病的胰腺癌患者中位生存期为9个月,未患糖尿病的胰腺癌患者为13个月。与未患糖尿病的患者相比,那些患有糖尿病并且采用口服降糖药或胰岛素控制血糖的患者其生存时间就更短了。我们还发现新发糖尿病(诊断时间小于4年)对胰腺癌患者的生存时间没有影响。

结论:在这三个纵向研究中都观察到长期患有糖尿病的胰腺癌患者其生存时间显著降低。

原始出处

Yuan C1, Rubinson DA1, Qian ZR1, Wu C1, Kraft P1, Bao Y1, Ogino S1, Ng K1, Clancy TE1, Swanson RS1, Gorman MJ1, Brais LK1, Li T1, Stampfer MJ1, Hu FB1, Giovannucci EL1, Kulke MH1, Fuchs CS1, Wolpin BM2.Survival among patients with pancreatic cancer and long-standing or recent-onset diabetes mellitus.J Clin Oncol. 2015 Jan

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    2015-05-25 lidong40
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    2015-04-11 x35042875

    他们的研究数据表明增加肠道中肠促胰素分泌细胞的数目,有可能成为改善血糖代谢的新型治疗方案。

    0

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    2015-01-13 lifefamily

    因为患者使用了胰岛素?或高胰岛素血症促进肿瘤进展?

    0

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