Does Hyperglycemia Predict Pancreatic Cancer Diagnosis?

高血糖可以预测胰腺癌的诊断吗？

• 批准号: 6712782
• 负责人: SURESH T. CHARI
• 金额: $ 24.27万
• 依托单位: MAYO CLINIC ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-04-01 至 2007-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6712782
• 关键词: biomarker; blood chemistry; blood glucose; cancer risk; case history; clinical research; diabetes mellitus; fasting; glucose tolerance test; hormone related neoplasm /cancer; human data; human middle age (35-64); hyperglycemia; longitudinal human study; medical complication; medical records; neoplasm /cancer diagnosis; pancreas neoplasms; statistics /biometry

DESCRIPTION (provided by applicant): Pancreatic cancer causes glucose intolerance and diabetes in up to 80% of patients. Pancreatic cancer induced diabetes (PaCDM) is often asymptomatic, of short duration (<3 years), and occurs at a resectable stage of the cancer. Up to 1% of newly diagnosed diabetics, equal to or >50 years of age may have PaCDM. We propose to establish whether newly elevated fasting blood glucose (FBG) is indicative of underlying pancreatic cancer as evidenced by diagnosis of pancreatic cancer within 3 years of the FBG measurement. If so, this would provide an entirely novel approach to screening for sporadic pancreatic cancer. We hypothesize that the 3-year likelihood of diagnosis of pancreatic cancer will be high in subjects: a) equal to or > 50 years of age with newly elevated FBG, b) with elevated fasting glucose who have known risk factors for pancreatic cancer (e.g. smoking), and/or c) who manifest an abrupt increase in FBG in serial measurements over time. We will identify visits to Mayo Clinic between years 1988 to 2002 by subjects equal to or >50 years of age who resided in its surrounding catchment area and had a routine physical examination that included a FBG. Preliminary data reveal that about 150,000 different subjects made >300,000 such visits during this time period providing >1 million person-years of follow-up. We will electronically retrieve clinical, and laboratory data and examine 3-year follow-up from date of FBG measurement to identify those diagnosed with pancreatic cancer. We expect 340 to 510 pancreatic cancer events in this cohort. Our Specific Aims are: Aim 1A). To test if FBG drawn during routine physical examination predicts likelihood of underlying pancreatic cancer and to test for non-linearity of this association. Aim 1B) To establish a FBG threshold that predicts a high 3-year likelihood of diagnosis of pancreatic cancer. Aim 2). To estimate the extent to which known risk factors for pancreatic cancer (age, smoking, obesity and family history) modify the likelihood of underlying pancreatic cancer in subjects with FBG greater than the threshold defined by Aim 1B. Aim 3). To test if patterns of change in serial measurements of FBG over time predict likelihood of underlying pancreatic cancer. The clinical and research implications of this study are considerable. These data may lead to delineation of individuals who have a high likelihood of existing pancreatic cancer, and who may be ideal candidates for more intensive screening or early detection regimens. The research described in this application is 100% relevant to pancreatic cancer.

描述（由申请人提供）：胰腺癌导致高达80%的患者葡萄糖耐受不良和糖尿病。胰腺癌诱导的糖尿病（PaCDM）通常无症状，病程短（<3年），发生在可切除的癌症阶段。在50岁或50岁以下的新诊断糖尿病患者中，高达1%的人可能患有PaCDM。我们建议确定空腹血糖（FBG）的新升高是否表明潜在的胰腺癌，因为在FBG测量的3年内诊断为胰腺癌。如果是这样，这将为散发性胰腺癌的筛查提供一种全新的方法。我们假设，3年诊断胰腺癌的可能性在以下受试者中很高：a)等于或50岁以上，新出现的空腹血糖升高，b)空腹血糖升高，已知胰腺癌的危险因素（如吸烟），和/或c)随着时间的推移，在一系列测量中表现出空腹血糖突然升高。我们将确定1988年至2002年间到梅奥诊所就诊的受试者，这些受试者年龄在50岁或50岁之间，居住在梅奥诊所周围的集水区，并进行了包括空腹血糖在内的常规体检。初步数据显示，在这段时间内，约有15万名不同的受试者进行了100万至30万次这样的访问，提供了100万人年的随访。我们将以电子方式检索临床和实验室数据，并检查从FBG测量之日起的3年随访，以确定诊断为胰腺癌的患者。我们预计在该队列中发生340 - 510例胰腺癌事件。我们的具体目标是：目标1A)。目的：检测常规体检中FBG是否能预测潜在胰腺癌的可能性，并检测这种关联的非线性。目的1B)建立FBG阈值，预测3年内胰腺癌诊断的高可能性。2)目标。估计已知胰腺癌危险因素（年龄、吸烟、肥胖和家族史）对FBG大于Aim 1B定义阈值受试者潜在胰腺癌可能性的影响程度。目标3)。测试FBG随时间序列测量的变化模式是否能预测潜在胰腺癌的可能性。本研究具有重要的临床和研究意义。这些数据可能会导致对现有胰腺癌的高可能性个体的描述，并且可能是更密集筛查或早期检测方案的理想候选人。本申请中描述的研究与胰腺癌100%相关。