Serum expression of angiopoietin-like protein 2 in pancreatic cancer patients with or without diabetes and its association with prognosis

Wen QIN; Taiwen CHEN; Haiping ZHENG; Xianing HUANG; Xiaodong ZHU

doi:10.3969/j.issn.1001-5256.2021.06.034

Volume 37 Issue 6

Jun. 2021

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Article Navigation > Journal of Clinical Hepatology > 2021 > 37(6): 1398-1403

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Serum expression of angiopoietin-like protein 2 in pancreatic cancer patients with or without diabetes and its association with prognosis

DOI: 10.3969/j.issn.1001-5256.2021.06.034

1a.
Department of Pathology, Wuming Hospital of Guangxi Medical University, Nanning 530199, China
1b.
Department of Oncology, Wuming Hospital of Guangxi Medical University, Nanning 530199, China
2.
Division of Gastric and Abdominal Oncology, Guangxi Medical University Cancer Hospital, Nanning 530021, China
3.
Department of Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China

Received Date: 2021-02-02
Accepted Date: 2021-03-15
Published Date: 2021-06-20

Abstract

Abstract

Objective To investigate the expression level of angiopoietin-like protein 2 (ANGPTL2) in pancreatic cancer patients with or without diabetes and the clinical value of ANGPTL2 as a prognostic marker in patients with pancreatic cancer. Methods Serum samples were collected from 125 pancreatic cancer patients who were treated in The First Affiliated Hospital of Guangxi Medical University, Guangxi Medical University Cancer Hospital, and Wuming Hospital of Guangxi Medical University from January 2015 to January 2018, among whom 64 had pancreatic cancer alone and 61 had pancreatic cancer and diabetes, and 66 individuals who underwent physical examination were enrolled as control group. ELISA was used to measure the serum level of ANGPTL2, and the association of the expression level of ANGPTL2 with clinical indices, survival, and prognosis was analyzed. A one-way analysis of variance was used for comparison of normally distributed continuous data between three groups, and the Bonferroni test was used for comparison between two groups. The independent-samples Kruskal-Wallis H test was used for comparison of continuous data with skewed distribution between three groups and the one-way ANOVA analysis was used for comparison between two groups. The chi-square test was used for comparison of categorical data between groups. Spearman correlation analysis was also performed to investigate correlation. The Kaplan-Meier method was used to plot survival curves, and the log-rank test was used for comparison of survival rate. The Cox risk model was used to perform univariate and multivariate analyses to determine independent risk factors for the prognosis of pancreatic cancer. Results The pancreatic cancer+diabetes group had a significantly higher serum concentration of ANGPTL2 than the pancreatic cancer group and the control group [7.79 (7.12-8.17) ng/ml vs 5.74 (5.08-6.40) ng/ml and 3.72 (3.25-4.16) ng/ml, χ²=126.367, P < 0.001]. Serum ANGPTL2 concentration was positively correlated with carbohydrate antigen 19-9 (CA19-9) and carcinoembryonic antigen (CEA) (r=0.560 and 0.731, both P < 0.001). The univariate analysis showed that tumor size, distant organ metastasis, degree of tumor differentiation, CEA, ANGPTL2, and HbA1c were closely associated with the long-term survival of pancreatic cancer patients, and the multivariate analysis showed that tumor size (HR=2.657, P=0.005), distant organ metastasis (HR=5.000, P=0.014), degree of tumor differentiation (HR=2.466, P=0.004), CEA(HR=1.110, P < 0.001) and ANGPTL2(HR=1.901, P=0.001) were independent risk factors for the prognosis of pancreatic cancer patients. For all pancreatic cancer patients, the high ANGPTL2 expression group had a significantly lower 2-year survival rate than the low ANGPTL2 expression group (8.51% vs 25.81%, χ²=5.651, P=0.017). For the pancreatic cancer patients with diabetes, the high ANGPTL2 expression group had a significantly lower 2-year survival rate than the low ANGPTL2 expression group (2.20% vs 32.70%, χ²=24.895, P < 0.001). Conclusion ANGPTL2 can be used as an effective clinical index to evaluate the prognosis of pancreatic cancer patients, especially those with diabetes.
- Pancreatic Neoplasms,
- Diabetes Mellitus,
- Angiopoietins,
- Prognosis

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References

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Serum expression of angiopoietin-like protein 2 in pancreatic cancer patients with or without diabetes and its association with prognosis

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Serum expression of angiopoietin-like protein 2 in pancreatic cancer patients with or without diabetes and its association with prognosis

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