Diabetes and Weight Loss Are Associated With Malignancies in Patients With Intraductal Papillary Mucinous Neoplasms

Pergolini, Ilaria; Jäger, Carsten; Safak, Okan; Goess, Ruediger; Novotny, Alexander; Ceyhan, Güralp O.; Frieß, Helmut; Demir, Ihsan Ekin

doi:10.1016/j.cgh.2020.04.090

Cited by 13 publications

(19 citation statements)

References 27 publications

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“…Moreover, in IPMN patients, T2D was associated with more frequent main-duct involvement and worse progression of IPMN into high-grade dysplasia and 2.7-fold higher risk to develop invasive PaCa [146].…”

Section: Pre-neoplastic Lesion As Additional Factorsmentioning

confidence: 94%

A review of lifestyle and environment risk factors for pancreatic cancer

Zanini

Renzi

Limongi

et al. 2021

European Journal of Cancer

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Section: Pre-neoplastic Lesion As Additional Factorsmentioning

confidence: 94%

A review of lifestyle and environment risk factors for pancreatic cancer

Zanini

Renzi

Limongi

et al. 2021

European Journal of Cancer

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“…Recently, other possible factors that may be associated with malignant IPMNs have also been reported. Pergolini et al [ 27 ]. pointed out that patients with IPMNs have a higher risk of high-grade dysplasia or invasive cancer when accompanied by diabetes or weight loss.…”

Section: Discussionmentioning

confidence: 99%

The association between serum ferritin levels and malignant intraductal papillary mucinous neoplasms

et al. 2021

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Background Serum ferritin levels are elevated in many malignancies. In this study, we showed the performance of serum ferritin in identifying malignant intraductal papillary mucinous neoplasms (IPMNs). Methods A total of 151 patients with pathologically confirmed IPMNs were enrolled. Serum tumor biomarker (carbohydrate antigen 19–9 (CA19–9) and carcinoembryonic antigen (CEA)) levels and serum ferritin levels were recorded. Lesion location, tumor size, diameter of the main pancreatic duct (MPD), mural nodule, and IPMN type, were collected from imaging examinations. IPMNs with high grade dysplasia and associated invasive carcinoma were considered malignant IPMNs. Results Serum ferritin levels in patients with malignant IPMNs were higher than those in patients with nonmalignant IPMNs (p < 0.05). Serum ferritin was an independent factor for the occurrence of malignant IPMNs (odds ratio (OR) = 1.18, 95% confidence interval (CI):1.01–1.39). A similar trend was found between high serum ferritin (> 149 ng/ml) and malignant IPMNs (OR = 5.64, 95% CI:1.78–17.92). The area under the curve (AUC) of serum ferritin was higher than that of CEA and CA19–9 in identifying malignant IPMNs (AUC = 0.67 vs. AUC = 0.58, 0.65). The combination of serum ferritin with IPMN type showed a similar performance to MPD diameter and the combination of serum CA19–9 with IPMN types in identifying malignant IPMNs (AUC = 0.78 vs. AUC = 0.79, 0.77) and invasive carcinoma (AUC = 0.77 vs. AUC = 0.79, 0.79). Conclusions Elevated serum ferritin is a factor associated with malignant IPMNs. Serum ferritin may be a useful marker for identifying malignancy in IPMNs.

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“… 9 As the precursor of PDA, IPMN and MCN were also reported to have a close relationship with diabetes, especially NODM. 10–12 The odds ratio of malignance in DM patients was 2.69 and 3.26, and the percentage was significantly elevated to 4.65 and 6.95 in NODM cases. 10 , 11 Because of this, it is logical to extrapolate that DM is a potential diagnostic predictor for invasive PCN diagnosis.…”

Section: Introductionmentioning

confidence: 87%

The Role of Diabetes Mellitus in the Malignant Pancreatic Cyst Neoplasm Diagnosis and Prognosis

Deng¹,

Guo²,

Gu³

et al. 2022

CMAR

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Purpose Pancreatic cyst neoplasm (PCN) is a precursor of pancreatic cancer. Previous studies reported PCN was often concurrent with diabetes. We aim to examine the association between diabetes with PCN malignancy and to detect the potential role of diabetes in PCN management and treatment. Patients and Methods A total of 224 patients who were diagnosed with the three major types of PCN (IPMN, MCN, and SCN) and underwent surgical resection were selected. Patients were divided into three groups (normal group, new-onset diabetes group (NODM) (<4years), and long-standing diabetes group (LSDM) (>4years)) according to diabetic history and diagnostic time interval. Diabetes, fast blood glucose level, HbA1c, and insulin resistance level were measured. Malignant PCN (mPCN) radiological features (worrisome features and high-risk stigmata) were analyzed. Pathological features (PCN type, dysplasia grade, tumor stage, and tumor volume) and immunohistology of Ki67 and SMAD4 were performed. Diagnostic efficacy of each variable was determined by the ROC curve. mPCN diagnosis was the main outcome in diagnostic prediction and overall survival as the glucose controlling outcome variables. Results Diabetes groups (NODM and LSDM) showed difference with the normal group in age, weight loss, malignancy, CA19-9 value, CEA value, Ki-67 value, tumor volume, pathological grade, and a lowered pancreatic fistula risk. NODM was related to insulin resistance, weight loss, and SMAD4 mutation. NODM (87.3%) and high insulin resistance rate (93.6%) significantly increased the sensitivity of radiological evidence-based mPCN diagnosis. Moreover, long-standing diabetes and elevated HbA1c led to reduced survival in mPCN patients than the normal PCN group. Anti-diabetic drugs showed limited influence on PCN malignancy and tumor volume. Conclusion NODM in PCN patients was associated with malignancy, insulin resistance, weight loss, and SMAD4 mutation. Prediabetic status and NODM diagnosis enhanced the diagnostic accuracy of radiological standards (worrisome features and high-risk stigmata). Stable glucose surveillance is necessary for mPCN patients’ survival.

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Diabetes and Weight Loss Are Associated With Malignancies in Patients With Intraductal Papillary Mucinous Neoplasms

Cited by 13 publications

References 27 publications

A review of lifestyle and environment risk factors for pancreatic cancer

A review of lifestyle and environment risk factors for pancreatic cancer

The association between serum ferritin levels and malignant intraductal papillary mucinous neoplasms

The Role of Diabetes Mellitus in the Malignant Pancreatic Cyst Neoplasm Diagnosis and Prognosis

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