Risk Factors for Sporadic Pancreatic Endocrine Tumors: A Case-Control Study of Prospectively Evaluated Patients
Risk Factors for Sporadic Pancreatic Endocrine Tumors: A Case-Control Study of Prospectively Evaluated Patients
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DOI：
10.1038/ajg.2009.466
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发表时间：
2009-12-01
影响因子：
9.8
通讯作者：
Delle Fave, Gianfranco
中科院分区：
文献类型：
--
作者：
Capurso, Gabriele;Falconi, Massimo;Delle Fave, Gianfranco
目的：胰腺内分泌肿瘤（PET）是一种异质性肿瘤，其患病率不断增加。关于散发性 PET 发生的分子发病机制和危险因素知之甚少。本研究的目的是确定与散发性 PET 发生相关的危险因素。方法：进行了一项病例对照研究，包括 162 例散发性 PET 和 648 例对照。使用有关人口统计和潜在危险因素的特定问卷对受试者进行访谈，这些危险因素包括吸烟、饮酒、身高、体重、病史和癌症家族史。采用逐步变量选择程序进行多重层次逻辑回归分析。结果：任何癌症的一级家族史都是一个显着的危险因素（比值比 (OR) 2.2；95% 置信区间 (CI)：1.5-3.2）。在不同的癌症部位中，PET 中胰腺腺癌的一级家族史比对照组更常见（4.3% vs. 1.2%；P=0.01）。大量饮酒（OR 4.8；95% CI：2.4-9.5）、慢性胰腺炎（CP）病史（OR 8.6；95% CI：1.4-51）和新发糖尿病（OR 40.1；95% CI：4.8-328.9）均为独立危险因素。诊断时的糖尿病史也与转移性疾病相关。结论：这项病例对照研究确定了任何癌症（以及较小程度的胰腺腺癌）家族史、CP、大量饮酒和新近发病的糖尿病作为 PET 的危险因素，从而表明与外分泌胰腺癌发生的危险因素可能部分重叠。
OBJECTIVES: Pancreatic endocrine tumors (PETs) are heterogeneous tumors with increasing prevalence. Little is known about the molecular pathogenesis and risk factors for the occurrence of sporadic PETs. The aim of this study was to identify the risk factors associated with the occurrence of sporadic PETs.METHODS: A case-control study comprising 162 sporadic PETs and 648 controls was undertaken. Subjects were interviewed using a specific questionnaire on demographics and potential risk factors, including smoking, alcohol, height, weight, medical history, and family history of cancer. A multiple hierarchical logistic regression analysis was performed with a stepwise variable-selection procedure.RESULTS: A first-degree family history of any cancer was a significant risk factor (odds ratio (OR) 2.2; 95% confidence interval (CI): 1.5-3.2). Among the different cancer sites, first-degree family history of pancreatic adenocarcinoma was more frequent in PETs than in controls (4.3 vs. 1.2%; P=0.01). A high alcohol intake (OR 4.8; 95% CI: 2.4-9.5), history of chronic pancreatitis (CP) (OR 8.6; 95 % CI: 1.4-51), and recent-onset diabetes (OR 40.1; 95% CI: 4.8-328.9) were all independent risk factors. The history of diabetes was also associated with metastatic disease at the time of diagnosis.CONCLUSIONS: This case-control study identified family history of any cancer (and to a less extent of pancreatic adenocarcinoma), CP, high alcohol intake, and recent-onset diabetes as risk factors for PET, thus suggesting a possible partial overlap with risk factors for exocrine pancreatic carcinogenesis.