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代谢综合征及其组分对胰腺癌患者预后的影响
Influence of metabolic syndrome and its components on the prognosis of patients with pancreatic cancer
文章发布日期:2020年11月13日  来源:  作者:陈欢,李婷,王紫洁,等  点击次数:2523次  下载次数:25次

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【摘要】:目的 评估代谢综合征及其组分与未经抗癌治疗的胰腺癌患者总体生存时间的关系。 方法 对2013年8月-2018年11月在西南医科大学附属医院诊断为胰腺癌患者的病例资料进行回顾性分析。收集的资料包括年龄、性别、体质量、身高、BMI、吸烟、饮酒、慢性胰腺炎病史、胆道疾病和胃炎病史、慢性乙型/丙型肝炎病史、其他癌症病史、一级亲属患胰腺癌、血糖、血压、HDL-C、TG水平、代谢综合征、TNM分期。采用log-rank检验比较各组生存曲线间是否有差异,采用单因素Cox回归模型和多因素Cox回归模型分析生存期的影响因素。结果 共纳入269例胰腺癌患者,平均生存时间为3个月。生存分析显示,是否存在代谢综合征患者之间的生存时间差异无统计学意义(P=0.754)。有无高血压、高TG、高HDL-C或BMI异常的患者之间的中位生存时间差异无统计学意义(P值均>0.05)。高血糖患者与无高血糖患者中位生存时间差异具有统计学意义(HR=1.322,95%CI:0.985~1.775,P=0.028),多因素Cox回归分析的结果与之一致(HR=1.481,95%CI:1.043~2.104,P=0.028)。单独对Ⅳ期患者的生存时间影响因素进行分析显示,高血糖患者的中位生存时间显著降低(HR=1.524,95%CI:1.046~2.218,P=0.004)。 结论 代谢综合征并非胰腺癌患者生存期的影响因素,而血糖升高是胰腺癌患者,尤其是晚期患者,较差预后的独立危险因素。
【Abstract】:Objective To investigate the association of metabolic syndrome (MS) and its components with the overall survival of pancreatic cancer (PC) patients who do not receive antitumor therapy. Methods A retrospective analysis was performed for the data of patients who were diagnosed with PC in The Affiliated Hospital of Southwest Medical University from August 2013 to November 2018. Related data were collected, including age, sex, body weight, body height, body mass index (BMI), smoking, drinking, medical history of chronic pancreatitis, medical history of biliary tract diseases and gastritis, medical history of chronic hepatitis B/C, medical history of other tumors, presence or absence of PC in first-grade relatives, blood glucose, blood pressure, high-density lipoprotein cholesterol (HDL-C), triglyceride (TG), MS, and TNM stage. The log-rank test was used for comparison of survival curves between groups, and the univariate and multivariate Cox regression analyses were used to investigate the influencing factors for survival. Results A total 269 PC patients were enrolled in this study, with an average survival time of 3 months. The survival analysis showed no significant difference in survival time between the patients with MS and those without MS (P=0.754). There was no significant difference in median survival time between the patients with hypertension, high TG, high HDL-C, or abnormal BMI and those without such abnormality (all P>0.05). There was a significant difference in median survival time between the patients with hyperglycemia and those without hyperglycemia (hazard ratio [HR]=1.322, 95% confidence interval [CI]: 0.985-1.775, P=0.028), and the multivariate Cox regression analysis achieved consistent results (HR=1.481, 95% CI: 1.043-2.104, P=0.028). The analysis of the influencing factors for survival time in patients with stage Ⅳ PC showed that the patients with hyperglycemia had a significant reduction in median survival time (HR=1.524, 95%CI: 1.046-2.218, P=0.004). Conclusion MS is not an influencing factor for the survival of PC patients, but hyperglycemia is an independent risk factor for poor prognosis in PC patients, especially in those with advanced PC.
【关键字】:胰腺肿瘤; 代谢综合征X; 高血糖症; 预后
【Key words】:pancreatic neoplasms; metabolic syndrome X; hyperglycemia; prognosis
【引证本文】:CHEN H, LI T, WANG ZJ, et al. Influence of metabolic syndrome and its components on the prognosis of patients with pancreatic cancer[J]. J Clin Hepatol, 2020, 36(12): 2788-2794. (in Chinese)
陈欢, 李婷, 王紫洁, 等. 代谢综合征及其组分对胰腺癌患者预后的影响[J]. 临床肝胆病杂志, 2020, 36(12): 2788-2794.

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