New-onset type 2 diabetes mellitus - A high-risk the screening of pancreatic cancer? group suitable for the screening of pancreatic cancer?
New-onset type 2 diabetes mellitus - A high-risk the screening of pancreatic cancer? group suitable for the screening of pancreatic cancer?
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DOI：
10.1016/j.pan.2015.12.005
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发表时间：
2016-03-01
期刊：
影响因子：
3.6
通讯作者：
Czako, Laszlo
中科院分区：
文献类型：
--
作者：
Illes, Dora;Terzin, Viktoria;Czako, Laszlo
背景资料：2型糖尿病被广泛认为与胰腺癌有关。目的：通过测定血清CA 19-9水平和腹部超声检查（US），确定新发2型糖尿病患者胰腺癌的发病率。所有患者均行血清CA 19-9测定和超声检查。如果两个中的任何一个是阳性的，则进行腹部计算机断层扫描（CT）。结果：共有115例患者入选。10例CA 19-9升高，但均未诊断为胰腺癌。3例CA 19-9水平无升高的患者经形态学检查发现胰腺癌。CA 19-9的敏感性、特异性、阳性预测值、阴性预测值和有效性分别为0%、90.4%、0%、97.9%和87.9%，US为66.7%、100%、100%、99%和99%。新发2型糖尿病患者胰腺癌的标化发病率为198.6（95%CI = 625 ~ 46.9）。结论：新发2型糖尿病患者胰腺癌的患病率明显高于普通人群，筛查有助于检测这一人群的PaC。CA 19-9和US不是该人群胰腺癌筛查的可靠筛查方式。(C)2015年，IAP和EPC。由爱思唯尔印度出版，里德爱思唯尔印度私人有限公司的一个部门。保留所有权利。
Background: Type 2 diabetes mellitus is widely considered to be associated with pancreatic cancer.Objective: To determine the incidence of pancreatic cancer in new-onset type 2 diabetic patients by measuring the serum level of CA 19-9 and performing abdominal ultrasonography (US).Patients and methods: Consecutive type 2 diabetic patients in whom diabetes was diagnosed within 36 months were included in this prospective study. Serum CA 19-9 measurement and US were performed in all patients. If any of two was positive, abdominal computer tomography (CT) was carried out. Endoscopic ultrasound-guided fine needle aspiration or direct surgical referral was performed on patients with CT-identified lesions.Results: A total of 115 patients were enrolled. CA 19-9 was elevated in 10 patients but pancreatic cancer diagnosed in neither of them. Pancreatic cancer was revealed by morphological means in three patients without elevated CA 19-9 level. The sensitivity, specificity, positive-, negative predictive values and validity were 0%, 90.4%, 0%, 97.9% and 87.9% for CA 19-9, 66.7%, 100%, 100%, 99% and 99% for US, respectively. The value of the Standardized Incidence Ratio for pancreatic cancer in new-onset type-2 diabetic patients was 198.6 (95% CI = 625-46.9).Conclusions: The prevalence of pancreatic cancer in patients with new-onset type-2 diabetes is significantly higher than that in the general population and screening is beneficial for detecting PaC in this patient population. CA 19-9 and US is not reliable screening modality for pancreatic cancer screening in this population. (C) 2015, IAP and EPC. Published by Elsevier India, a division of Reed Elsevier India Pvt. Ltd. All rights reserved.