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ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 38 Issue 12
Dec.  2022
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Article Contents

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

DOI: 10.3969/j.issn.1001-5256.2022.12.018
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
  •   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.

     

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