Clinical characteristics of patients with pancreatic cancer combined with new onset diabetes mellitus

Qian ZHAO; Yongliang FENG; Yan WANG; Zhigang WEI

doi:10.3969/j.issn.1001-5256.2022.12.018

Volume 38 Issue 12

Dec. 2022

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Article Navigation > Journal of Clinical Hepatology > 2022 > 38(12): 2780-2786

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Clinical characteristics of patients with pancreatic cancer combined with new onset diabetes mellitus

DOI: 10.3969/j.issn.1001-5256.2022.12.018

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

Research funding:

Key R&D projects in Shanxi Province (201903D321144);

Shanxi Provincial Health Planning Commission "Four Batches" Innovation Plan to Guide the Work of Science and Technology Special (2021XM53)

More Information

Corresponding author: WEI Zhigang, wzgsyyy@163.com (ORCID: 0000-0002-2328-2843)
Received Date: 2022-05-13
Accepted Date: 2022-06-30
Published Date: 2022-12-20

Abstract

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 (χ²=3.950, P=0.047), a lower family history of DM (χ²=3.893, P=0.048), a lower FPG level (Z=-2.740, P=0.005), a higher proportion of smokers (χ²=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 (χ²=4.870, P=0.027), and significant differences in DM medication (χ²=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 (χ²=17.438, P < 0.001), a higher FPG level (Z=-8.322, P < 0.001), and a high proportion of dilated pancreatic ducts (χ²=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.
- Pancreatic Neoplasms,
- Diabetes Mellitus,
- Pathology, Clinical

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References

[1]	SIEGEL RL, MILLER KD, FUCHS HE, et al. Cancer Statistics, 2021[J]. CA Cancer J Clin, 2021, 71(1): 7-33. DOI: 10.3322/caac.21654.
[2]	CAO W, CHEN HD, YU YW, et al. Changing profiles of cancer burden worldwide and in China: a secondary analysis of the global cancer statistics 2020[J]. Chin Med J (Engl), 2021, 134(7): 783-791. DOI: 10.1097/CM9.0000000000001474.
[3]	SHI CG, LIU XH, XIE YX, et al. Research advances in pancreatic exocrine insufficiency secondary to pancreatic cancer[J]. J Clin Hepatol, 2021, 37(4): 982-984. DOI: 10.3969/j.issn.1001-5256.2021.04.057. 史晨光, 刘晓欢, 谢亚兴, 等. 继发于胰腺癌的胰腺外分泌功能不全的研究进展[J]. 临床肝胆病杂志, 2021, 37(4): 982-984. DOI: 10.3969/j.issn.1001-5256.2021.04.057.
[4]	ZHANG LX, ZHAO HR, ZHANG ZQ. On the effect of Roy adaptation mode nursing on negative emotion and postoperative pain in patients with pancreatic cancer[J]. J Changchun Univ Chin Med, 2021, 37(1): 171-173. DOI: 10.13463/j.cnki.cczyy.2021.01.046. 张连香, 赵海蓉, 张志琴. Roy适应模式护理对胰腺癌患者负性情绪及术后疼痛程度的影响分析[J]. 长春中医药大学学报, 2021, 37(1): 171-173. DOI: 10.13463/j.cnki.cczyy.2021.01.046.
[5]	ZHANG JJ, JIA JP, SHAO Q, et al. Diabetes mellitus and risk of pancreatic cancer in China: A meta-analysis based on 26 case-control studies[J]. Prim Care Diabetes, 2019, 13(3): 276-282. DOI: 10.1016/j.pcd.2018.11.015.
[6]	ANDERSEN DK, KORC M, PETERSEN GM, et al. Diabetes, pancreatogenic diabetes, and pancreatic cancer[J]. Diabetes, 2017, 66(5): 1103-1110. DOI: 10.2337/db16-1477.
[7]	HUANG BZ, PANDOL SJ, JEON CY, et al. New-onset diabetes, longitudinal trends in metabolic markers, and risk of pancreatic cancer in a heterogeneous population[J]. Clin Gastroenterol Hepatol, 2020, 18(8): 1812-1821.e7. DOI: 10.1016/j.cgh.2019.11.043.
[8]	LI Y, TENG D, SHI X, et al. Prevalence of diabetes recorded in mainland China using 2018 diagnostic criteria from the American Diabetes Association: national cross sectional study[J]. BMJ, 2020, 369: m997. DOI: 10.1136/bmj.m997.
[9]	BOND-SMITH G, BANGA N, HAMMOND TM, et al. Pancreatic adenocarcinoma[J]. BMJ, 2012, 344: e2476. DOI: 10.1136/bmj.e2476.
[10]	BOURSI B, FINKELMAN B, GIANTONIO BJ, et al. A clinical prediction model to assess risk for pancreatic cancer among patients with prediabetes[J]. Eur J Gastroenterol Hepatol, 2022, 34(1): 33-38. DOI: 10.1097/MEG.0000000000002052.
[11]	HUANG J, LOK V, NGAI CH, et al. Worldwide burden of, risk factors for, and trends in pancreatic cancer[J]. Gastroenterology, 2021, 160(3): 744-754. DOI: 10.1053/j.gastro.2020.10.007.
[12]	MIDHA S, CHAWLA S, GARG PK. Modifiable and non-modifiable risk factors for pancreatic cancer: A review[J]. Cancer Lett, 2016, 381(1): 269-277. DOI: 10.1016/j.canlet.2016.07.022.
[13]	MAISONNEUVE P. Epidemiology and burden of pancreatic cancer[J]. Presse Med, 2019, 48(3 Pt 2): e113, e123. DOI: 10.1016/j.lpm.2019.02.030.
[14]	DONG X, LOU YB, MU YC, et al. Predictive factors for differentiating pancreatic cancer-associated diabetes mellitus from common type 2 diabetes mellitus for the early detection of pancreatic cancer[J]. Digestion, 2018, 98(4): 209-216. DOI: 10.1159/000489169.
[15]	CAI J, CHEN H, LU M, et al. Advances in the epidemiology of pancreatic cancer: Trends, risk factors, screening, and prognosis[J]. Cancer Lett, 2021, 520: 1-11. DOI: 10.1016/j.canlet.2021.06.027.
[16]	MATSUBAYASHI H, KIYOZUMI Y, ISHIWATARI H, et al. Surveillance of individuals with a family history of pancreatic cancer and inherited cancer syndromes: A strategy for detecting early pancreatic cancers[J]. Diagnostics(Basel), 2019, 9(4). DOI: 10.3390/diagnostics9040169.
[17]	LANG J, KUNOVSKÝ L, KALA Z, et al. Risk factors of pancreatic cancer and their possible uses in diagnostics[J]. Neoplasma, 2021, 68(2): 227-239. DOI: 10.4149/neo_2020_200706N699.
[18]	ZHANG FY, ADILA YKP, ZHAO JM, et al. New advances in the treatment of pancreatic cancer by targeting tumor microenvironment[J]. J Clin Hepatol, 2021, 37(9): 2246-2248. DOI: 10.3969/j.issn.1001-5256.2021.09.049. 张飞宇, 阿迪拉·亚克普, 赵金明, 等. 靶向肿瘤微环境治疗胰腺癌的新进展[J]. 临床肝胆病杂志, 2021, 37(9): 2246-2248. DOI: 10.3969/j.issn.1001-5256.2021.09.049.
[19]	MA ML, ZHOU MC, YANG J, et al. Clinical characteristics of pancreatic cancer with different duration of diabetes and impact of related risk factors on onset age of pancreatic cancer[J]. Med J Peking Union Med Coll Hosp, 2015, 6(6): 419-426. DOI: 10.3969/j.issn.1674-9081.2015.06.005. 马明磊, 周美岑, 杨婧, 等. 合并不同糖尿病病程的胰腺癌患者临床特征及相关危险因素对胰腺癌发病年龄的影响[J]. 协和医学杂志, 2015, 6(6): 419-426. DOI: 10.3969/j.issn.1674-9081.2015.06.005.
[20]	Collaborative Group of Pancreatic Diseases, Gastrointestinal Endoscopy Branch. Chinese consensus on the early screening and surveillance for pancreatic cancer in the high-risk individuals(2021, Nanjing)[J]. Chin J Pancretol, 2022, 22(1): 1-13. DOI: 10.3760/cma.j.cn115667-20211224-00224. 中华医学会消化内镜学分会胰腺疾病协作组. 中国胰腺癌高危人群早期筛查和监测共识意见(2021, 南京)[J]. 中华胰腺病杂志, 2022, 22(1): 1-13. DOI: 10.3760/cma.j.cn115667-20211224-00224.
[21]	PANNALA R, LEIRNESS JB, BAMLET WR, et al. Prevalence and clinical profile of pancreatic cancer-associated diabetes mellitus[J]. Gastroenterology, 2008, 134(4): 981-987. DOI: 10.1053/j.gastro.2008.01.039.
[22]	SAH RP, NAGPAL SJ, MUKHOPADHYAY D, et al. New insights into pancreatic cancer-induced paraneoplastic diabetes[J]. Nat Rev Gastroenterol Hepatol, 2013, 10(7): 423-433. DOI: 10.1038/nrgastro.2013.49.
[23]	SHAO CW. Focus on the diagnosis of pancreatic diseases from the perspective of pancreatic duct changes[J]. Chin J Pancretol, 2021, 21(6): 401-405. DOI: 10.3760/cma.j.cn115667-20211016-00184. 邵成伟. 从胰管改变谈胰腺疾病的诊断[J]. 中华胰腺病杂志, 2021, 21(6): 401-405. DOI: 10.3760/cma.j.cn115667-20211016-00184.

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Clinical characteristics of patients with pancreatic cancer combined with new onset diabetes mellitus

DOI: 10.3969/j.issn.1001-5256.2022.12.018

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Clinical characteristics of patients with pancreatic cancer combined with new onset diabetes mellitus

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