Diabetes mellitus, other medical conditions and familial history of cancer as risk factors for pancreatic cancer.
Diabetes mellitus, other medical conditions and familial history of cancer as risk factors for pancreatic cancer.
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DOI：
10.1038/sj.bjc.6690607
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发表时间：
1999-08
影响因子：
8.8
通讯作者：
Fraumeni, JF
中科院分区：
文献类型：
--
作者：
Silverman, DT;Schiffman, M;Everhart, J;Goldstein, A;Lillemoe, KD;Swanson, GM;Schwartz, AG;Brown, LM;Greenberg, RS;Schoenberg, JB;Pottern, LM;Hoover, RN;Fraumeni, JF
在美国三个地区进行的一项基于人群的胰腺癌病例对照研究中，对484例病例和2099例对照进行了访谈，以评估几种医疗条件/干预措施的病因学作用，包括糖尿病、胆囊切除术、溃疡/胃切除术和过敏状态。我们还评估了与癌症家族史相关的风险。我们的发现支持了先前的研究，即糖尿病是胰腺癌的危险因素，也是肿瘤的可能并发症。随着胰腺癌诊断前年份的增加，风险呈明显的正趋势（趋势检验的p值= 0.016），诊断前至少10年的糖尿病患者的风险显著增加50%。接受胰岛素治疗的患者与未接受胰岛素治疗的患者的风险相似（优势比分别为1.6和1.5），并且风险趋势与胰岛素治疗持续时间的增加无关。胆囊切除术似乎也是一个危险因素，以及恶性肿瘤的后果。在胰腺癌诊断前至少20年做过胆囊切除术的受试者患胰腺癌的风险增加了70%，这一结果具有轻微的统计学意义。相比之下，有十二指肠溃疡或胃溃疡病史的受试者风险很少或没有升高（or = 1.2；置信区间= 0.9-1.6）。接受胃切除术的患者与未接受手术的患者患胰腺癌的风险相同，这几乎不能支持胃切除术是胰腺癌风险因素的假设。花粉症患者的风险显著降低40%，对动物过敏患者的风险显著降低50%，对灰尘/霉菌过敏患者的风险显著降低40%。然而，这些关联可能是偶然的，因为哮喘或其他几种过敏的风险没有明显降低。此外，我们观察到，报告一级亲属患有胰腺癌（OR = 3.2）、结肠癌（OR = 1.7）或卵巢癌（OR = 5.3）的受试者的风险显著增加，而子宫内膜癌（OR = 1.5）或乳腺癌（OR = 1.3）的风险无显著增加。这种模式与报道的胰腺癌的家族易感性和与遗传性非息肉性结肠癌相关的一系列肿瘤一致。©1999癌症研究运动
In a population-based case-control study of pancreatic cancer conducted in three areas of the USA, 484 cases and 2099 controls were interviewed to evaluate the aetiologic role of several medical conditions/interventions, including diabetes mellitus, cholecystectomy, ulcer/gastrectomy and allergic states. We also evaluated risk associated with family history of cancer. Our findings support previous studies indicating that diabetes is a risk factor for pancreatic cancer, as well as a possible complication of the tumour. A significant positive trend in risk with increasing years prior to diagnosis of pancreatic cancer was apparent (P-value for test of trend = 0.016), with diabetics diagnosed at least 10 years prior to diagnosis having a significant 50% increased risk. Those treated with insulin had risks similar to those not treated with insulin (odds ratio (OR) = 1.6 and 1.5 respectively), and no trend in risk was associated with increasing duration of insulin treatment. Cholecystectomy also appeared to be a risk factor, as well as a consequence of the malignancy. Subjects with a cholecystectomy at least 20 years prior to the diagnosis of pancreatic cancer experienced a 70% increased risk, which was marginally significant. In contrast, subjects with a history of duodenal or gastric ulcer had little or no elevated risk (OR = 1.2; confidence interval = 0.9–1.6). Those treated by gastrectomy had the same risk as those not receiving surgery, providing little support for the hypothesis that gastrectomy is a risk factor for pancreatic cancer. A significant 40% reduced risk was associated with hay fever, a non-significant 50% decreased risk with allergies to animals, and a non-significant 40% reduced risk with allergies to dust/moulds. These associations, however, may be due to chance since no risk reductions were apparent for asthma or several other types of allergies. In addition, we observed significantly increased risks for subjects reporting a first-degree relative with cancers of the pancreas (OR = 3.2), colon (OR = 1.7) or ovary (OR = 5.3) and non-significantly increased risks for cancers of the endometrium (OR = 1.5) or breast (OR = 1.3). The pattern is consistent with the familial predisposition reported for pancreatic cancer and with the array of tumours associated with hereditary non-polyposis colon cancer. © 1999 Cancer Research Campaign
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