| Objective:Pancreatic cancer is one of the malignant tumors of the digestive tract,and its malignancy is very high.The morbidity and mortality of pancreatic cancer have been increasing for many years,and the burden of cancer is still at a stable high level.At present,the etiology of pancreatic cancer is not clear,and the symptoms and signs of patients are not specific.Most of the cancers have metastasized during treatment,so the treatment opportunities for pancreatic cancer are limited and the prognosis is very poor.This study collected epidemiological data of pancreatic cancer risk factors,explored the correlation between metabolic syndrome(MetS)or other possible risk factor components and pancreatic cancer in inpatients in the southwestern region of Sichuan,China,and determined the relevance of several related risk factors to influence the prognosis of pancreatic cancer.This may provide a theoretical basis for the prevention and treatment of pancreatic cancerMethods:From August 2013 to November 2018,1080 pancreatic cancers that met clinical diagnosis was selected among the four tertiary hospitals in Southwest China(Affiliated Hospital of Southwest Medical University,Second Affiliated Hospital of Chongqing Medical University,Southwest Hospital,and Nanchong Central Hospital)were used as the Cases group.From the different departments of the four hospitals at the same time,1619 inpatients of Han nationality and non-tumor matched with gender and age were randomly selected as the control group.Collecting epidemiological data of potential risk factors at the first visit of the patient,including gender,age,height,weight,smoking history,alcohol consumption History,history of hypertension,history of diabetes,history of chronic pancreatitis,history of first-degree relatives of pancreatic cancer,ABO blood type,the first test results of admission such as fasting blood glucose,blood pressure,blood lipid(triglycerides,high density Measured values of lipoprotein cholesterol),hepatitis B surface antigen(HBsAg),and hepatitis C antibody(HCV).The survival time(/month)of patients with pancreatic cancer was obtained through clinical records and telephone follow-up of patients with pancreatic cancer or their family members.A retrospective Case-control analysis was performed to explore the relevance and prognostic value of pancreatic cancer.Data were analyzed using SPSS 17.0 software,and unconditional logistic regression models were used for single and multi-factor analysis of risk factors,and correction rates[AOR]and 95%confidence intervals[CI]for possible confounding factors were calculated.Second,according to the data of 269 eligible pancreatic cancer patients,the median survival time and its 95%Cl statistical description were used for the survival time.Log-Rank test was used to make statistical inferences between the groups.Multivariate analysis used the Cox risk model;OS curves were compared using Kaplan-Meier survival analysis.Results:(1).Analysis of MetS and potential risk factors:1080 Cases of pancreatic cancer(659 men and 421 women)were included in the study Cases group,and 1619 patients(988 men and 631 women)in the control group.The average age was 64.0 years old,and males accounted for 61.0%.Univariate analysis results showed that smoking history,drinking history,chronic pancreatitis,diabetes history,history of hypertension,history of first-degree relatives of pancreatic cancer,hepatitis C antibody positive,and MetS components had statistical differences in risk analysis for pancreatic cancer,but When MetS as a whole,there is no correlation.Using unconditional logistic regression model to control the potential confounding factors of pancreatic cancer,it was concluded that the single component of MetS(except high BMI)is a significant independent risk factor for pancreatic cancer(OR>1.0),chronic pancreatitis,HBsAg+(active infection Or inactive carriers)still increase the risk of pancreatic cancer.Second,the combination analysis of MetS showed that the key components in MetS may be high fasting blood glucose/diabetes;the five components of MetS have a greater impact on the risk of pancreatic cancer than the MetS as a whole.Even if it may not meet the diagnostic criteria of MetS,such as containing several MetS components,such as high blood lipids(high TG or low HDL-C)and high blood sugar/diabetes,it is significantly associated with pancreatic cancer risk(OR=5.308,95%CI:4.179-6.743,P<0.001).(2)Prognostic analysis of pancreatic cancer:The overall average survival time of 269 untreated pancreatic cancer patients was 3.2 months,and most of the patients were from stage IV(83.3%).The median survival time for patients with stage Ⅰ-Ⅲ pancreatic cancer was 4.0m(95%Cl=3.2 to 4.8),compared with only 2.0m for patients with stage IV pancreatic cancer(95%Cl=1.7 to 2.2).The median survival time for patients with high fasting blood glucose/diabetes was 2.0 m(95%CI=1.7 to 2.3),while the median survival time for patients with normal fasting blood glucose/non-diabetics was 3.0 m(95%CI=2.3 to 3.7).The data of both groups were statistically significant(P<0.05).Second,univariate and multivariate analysis results indicate that the two independent risk factors associated with poor prognosis of this type of pancreatic cancer are high TNM stage(clinical stage Ⅳ)and abnormal blood glucose(high fasting blood glucose/diabetes)in the MetS component.However,Age(>65 years),gender,smoking,drinking,chronic pancreatitis,history of first-degree relatives,HBsAg(+),anti-HCV(+),and MetS as a whole were not significantly related to the patient’s prognosisConclusions:1.The patients with pancreatic cancer in this data are mostly elderly,males.Univariate and multivariate results show that the single component of MetS(except high BMI)is a significant independent risk factor for pancreatic cancer.Chronic pancreatitis and HBsAg+(active infection or inactive carriers)still increase the risk of pancreatic cancer.2.The five components of MetS have a greater impact on the risk of pancreatic cancer than the overall MetS.The key component in MetS seems to be high fasting blood glucose/diabetes;even if it may not meet the diagnostic criteria of MetS,it also contains several MetS components(such as hyperlipidemia and fasting blood glucose/diabetes)are significantly associated with pancreatic cancer risk.3.The overall survival time of untreated pancreatic cancer is short and most patients come from stage Ⅳ.TNM stage IV and high fasting blood glucose/diabetes in the MetS component are independent related risk factors for poor prognosis in patients with this type of pancreatic cancer.The median survival time of the two groups of patients was very short(both only 2.0m),which was statistically significant. |
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