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）：胰腺癌导致多达80％的患者导致葡萄糖不耐症和糖尿病。胰腺癌诱导的糖尿病（PACDM）通常是无症状的，持续时间短（<3年），发生在癌症的可切除阶段。等于或> 50岁的新诊断糖尿病患者中，多达1％的糖尿病患者可能患有PACDM。我们建议确定新升高的空腹血糖（FBG）是否表明了潜在的胰腺癌，这在FBG测量后的3年内诊断出胰腺癌证明了。如果是这样，这将为零星胰腺癌的筛查提供一种全新的方法。我们假设胰腺癌诊断的三年可能性在受试者中会很高：a）等于或> 50岁以上的FBG升高，b）空腹葡萄糖的升高，其胰腺癌的已知风险因素升高（例如吸烟），例如吸烟），以及/或C）在表现出频率高度衡量中的突然增加。我们将在1988年至2002年之间通过等于或> 50岁的受试者在其周围的集水区居住，并进行了常规的体格检查，其中包括FBG。初步数据显示，在此期间，大约有15万个不同的受试者进行了> 300,000个此类访问，提供了> 100万人的随访。我们将电子检索临床和实验室数据，并检查FBG测量日期以来为期3年的随访，以识别诊断为胰腺癌的人。我们预计该队列中有340至510个胰腺癌事件。我们的具体目的是：目标1A）。为了测试常规体格检查期间的FBG是否预测了潜在的胰腺癌的可能性并测试该关联的非线性。目标1B）建立一个FBG阈值，该阈值可以预测胰腺癌诊断的3年可能性。目标2）。为了估计胰腺癌（年龄，吸烟，肥胖和家族史）已知的危险因素在多大程度上改变了FBG受试者的潜在胰腺癌的可能性大于AIM 1B定义的阈值。目标3）。为了测试FBG串行测量的变化模式是否会随着时间的流逝预测胰腺癌的可能性。这项研究的临床和研究意义是相当大的。这些数据可能导致划定现有胰腺癌可能性很大的个体，并且可能是更深入筛查或早期检测方案的理想候选者。该应用中描述的研究与胰腺癌100％有关。