Influence of Klebsiella pneumoniae and quinolone treatment on prognosis in patients with pancreatic cancer.
Influence of Klebsiella pneumoniae and quinolone treatment on prognosis in patients with pancreatic cancer.
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肺炎克雷伯菌和喹诺酮类药物治疗对胰腺癌患者预后的影响
DOI：
10.1002/bjs.12003
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发表时间：
2020
期刊：
影响因子：
--
通讯作者：
Fernandez CF
中科院分区：
文献类型：
--
作者：
Weniger M;Hank T;Qadan M;Ciprani D;Michelakos T;Niess H;Heiliger C;Ilmer M;D’Haese JG;Ferrone CR;Warshaw AL;Lillemoe KD;Werner J;Liss AS;Fernandez CF
背景越来越多的证据表明，微生物群可能促进胰腺导管腺癌（PDAC）的进展。据推测，γ-变形菌方法这是一项对来自马萨诸塞州总医院（美国）和路德维希-马克西米利安大学（德国）的患者的回顾性研究，这些患者在2007年1月至2017年12月期间接受了局部晚期或边缘可切除的PDAC的术前治疗和胰腺切除术，并且可以获得胆汁培养物。研究了肿瘤特征、生存数据、抗生素使用和术中胆汁培养结果之间的关系。使用Kaplan-Meier曲线和考克斯回归分析对生存率进行分析。结果对总共211名患者的分析显示，术中胆汁培养中发现的病原体种类的增加与无进展生存率（PFS）的降低相关（-1统计9（95% c.i.每个物种-3统计3至-0统计5）个月;P= 0·009）。吉西他滨辅助治疗可改善K阴性患者的PFS。肺炎支原体感染者（26.2个月对15.3个月;P = 0.039），但在检测阳性者（19.5个月对13.2个月;P = 0.137）中无明显差异。喹诺酮治疗与中位总生存期（OS）的改善相关，与K无关。肺炎（48.8个月对26.2个月，P = 0.006）和K.肺炎（中位数未达到对18.8个月;P = 0.028）。喹诺酮类耐药患者K.肺炎克雷伯氏菌的PFS短于喹诺酮敏感性肺炎克雷伯氏菌。肺炎（9·1个月对18·8个月;P =0·001）。肺炎可能促进对辅助吉西他滨的化疗耐药性，喹诺酮治疗与生存率提高有关。
BackgroundAn increasing body of evidence suggests that microbiota may promote progression of pancreatic ductal adenocarcinoma (PDAC). It was hypothesized that gammaproteobacteria (such asKlebsiella pneumoniae) influence survival in PDAC, and that quinolone treatment may attenuate this effect.MethodsThis was a retrospective study of patients from the Massachusetts General Hospital (USA) and Ludwig‐Maximilians‐University (Germany) who underwent preoperative treatment and pancreatoduodenectomy for locally advanced or borderline resectable PDAC between January 2007 and December 2017, and for whom a bile culture was available. Associations between tumour characteristics, survival data, antibiotic use and results of intraoperative bile cultures were investigated. Survival was analysed using Kaplan–Meier curves and Cox regression analysis.ResultsAnalysis of a total of 211 patients revealed that an increasing number of pathogen species found in intraoperative bile cultures was associated with a decrease in progression‐free survival (PFS) (–1·9 (95 per cent c.i. –3·3 to –0·5) months per species;P= 0·009). Adjuvant treatment with gemcitabine improved PFS in patients who were negative forK. pneumoniae(26·2versus15·3 months;P =0·039), but not in those who tested positive (19·5versus13·2 months;P =0·137). Quinolone treatment was associated with improved median overall survival (OS) independent ofK. pneumoniaestatus (48·8versus26·2 months;P =0·006) and among those who tested positive forK. pneumoniae(median not reachedversus18·8 months;P =0·028). Patients with quinolone‐resistantK. pneumoniaehad shorter PFS than those with quinolone‐sensitiveK. pneumoniae(9·1versus18·8 months;P =0·001).ConclusionK. pneumoniaemay promote chemoresistance to adjuvant gemcitabine, and quinolone treatment is associated with improved survival.
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影响因子：
45.3
作者：
Versteijne, Eva;Suker, Mustafa;van Tienhoven, Geertjan
通讯作者：
van Tienhoven, Geertjan
影响因子：
9.6
作者：
Verbeke, C. S.;Leitch, D.;Anthoney, A.
通讯作者：
Anthoney, A.
影响因子：
28.2
作者：
Pushalkar S;Hundeyin M;Daley D;Zambirinis CP;Kurz E;Mishra A;Mohan N;Aykut B;Usyk M;Torres LE;Werba G;Zhang K;Guo Y;Li Q;Akkad N;Lall S;Wadowski B;Gutierrez J;Kochen Rossi JA;Herzog JW;Diskin B;Torres-Hernandez A;Leinwand J;Wang W;Taunk PS;Savadkar S;Janal M;Saxena A;Li X;Cohen D;Sartor RB;Saxena D;Miller G
通讯作者：
Miller G
DOI：
10.1016/j.ejca.2015.08.015
发表时间：
2015-11
期刊：
European journal of cancer (Oxford, England : 1990)
影响因子：
--
作者：
Boursi B;Mamtani R;Haynes K;Yang YX
通讯作者：
Yang YX
影响因子：
29.4
作者：
Sethi V;Kurtom S;Tarique M;Lavania S;Malchiodi Z;Hellmund L;Zhang L;Sharma U;Giri B;Garg B;Ferrantella A;Vickers SM;Banerjee S;Dawra R;Roy S;Ramakrishnan S;Saluja A;Dudeja V
通讯作者：
Dudeja V