Signs and Symptoms of Pancreatic Cancer: A Population-Based Case-Control Study in the San Francisco Bay Area
Signs and Symptoms of Pancreatic Cancer: A Population-Based Case-Control Study in the San Francisco Bay Area
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DOI：
10.1016/s1542-3565(04)00171-5
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发表时间：
2004-06-01
影响因子：
12.6
通讯作者：
Gautam, Manjushree
中科院分区：
文献类型：
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作者：
Holly, Elizabeth A.;Chaliha, Indranushi;Gautam, Manjushree
背景与目的：胰腺癌通常不会引起明确的症状，直到生存严重受损。迫切需要预防和早期发现。我们的目的是在一项基于人群的研究中收集和分析胰腺癌患者和对照参与者报告的疾病体征和症状的数据，以促进早期检测和更好的预后。研究方法：对120名连续胰腺癌患者进行了补充症状问卷调查，这些患者是1994年至2001年在旧金山弗朗西斯科湾区进行的一项更大规模的基于人群的病例对照研究的一部分。180名年龄和性别匹配的人群对照参与者也被询问了至少5%的胰腺癌患者报告的相同症状。结果：病例组和对照组的症状和体征多发生在确诊前3年内。与对照组相比，患者更容易报告许多体征和症状，包括食欲不振（比值比[OR]，41; 95%置信区间[CI]，14-120），苍白便（OR，31; 95% CI，7.3-134），腹痛（OR，30; 95% CI，9.1-101），黄疸（OR，20; 95% CI，8.0-49），异常腹胀（OR，20; 95% CI，5.9-67），不寻常的打嗝（OR，17; 95%CI，3.9-75），体重减轻（OR，12; 95% CI，5.2-28），深色尿液（OR，10; 95% CI，2.9-36），便秘（OR，7.3; 95% CI，2.0-26），腹泻（OR，5.6; 95% CI，2.0-16），瘙痒（OR，5.0; 95% CI，2.3-11）、疲劳（OR，3.8; 95% CI，2.0-7.3）、睡眠能力改变（OR，2.9; 95% CI，1.3-6.3）和不寻常的胃灼热（OR，2.3; 95% CI，1.2-4.5）。结论：我们的研究结果表明，胰腺癌患者的症状和体征可能是胰腺癌的指标，其发生率明显高于基于人群的对照组。大量的风险估计表明，常见的胃肠道症状可能有助于临床医生早期诊断胰腺癌，并可能影响生存率。
Background & Aims: Pancreatic cancer usually does not cause definitive symptoms until survival is severely compromised. Prevention and early detection are urgently needed. Our aim was to collect and analyze data in a population-based study on signs and symptoms of disease reported by patients with pancreatic cancer and control participants to contribute to earlier detection and better prognosis. Methods: A supplemental symptoms questionnaire was administered to 120 consecutive patients with pancreatic cancer who were part of a larger population-based case-control study conducted in the San Francisco Bay Area between 1994 and 2001. One hundred eighty age-and sex-matched population-based control participants also were queried about the same symptoms reported by at least 5% of patients with pancreatic cancer. Results: Most signs and symptoms occurred within 3 years before diagnosis with pancreatic cancer (cases) and interview (controls). Many signs and symptoms were more likely to have been reported by patients compared with control participants and included appetite loss (odds ratio [OR], 41; 95% confidence interval [CI], 14-120), pale stools (OR, 31; 95% CI, 7.3-134), abdominal pain (OR, 30; 95% CI, 9.1-101), jaundice (OR, 20; 95% CI, 8.0-49), unusual bloating (OR, 20; 95% CI, 5.9-67), unusual belching (OR, 17; 95% CI, 3.9-75), weight loss (OR, 12; 95% CI, 5.2-28), dark urine (OR, 10; 95% CI, 2.9-36), constipation (OR, 7.3; 95% CI, 2.0-26), diarrhea (OR, 5.6; 95% CI, 2.0-16), itching (OR, 5.0; 95% CI, 2.3-11), fatigue (OR, 3.8; 95% CI, 2.0-7.3), altered ability to sleep (OR, 2.9; 95% CI, 1.3-6.3), and unusual heartburn (OR, 2.3; 95% CI, 1.2-4.5). Conclusions: Our results show that signs and symptoms likely to be indicators of pancreatic cancer occur substantially more often among patients with pancreatic cancer than among population-based controls. The large magnitude of the risk estimates indicate that common gastrointestinal symptoms may assist clinicians in earlier diagnosis of pancreatic cancer and perhaps affect survival.