膵癌のリスクファクターとしての糖尿病 : 効率的な膵癌スクリーニングを目指して Diabetes mellitus as a risk factor for pancreatic cancer : For the realization of efficient screening of pancreatic cancer in patients with diabetes mellitus

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【目的】糖尿病患者における,膵癌の効率的なスクリーニング法の確立を目指し,糖尿病合併膵癌患者の臨床的背景をretrospectiveに検討した.【方法】膵癌(IPMCは除く)466例のうち発見時すでに糖尿病を合併していた68例を対象とした.糖尿病関連発見群:糖尿病の増悪を契機に発見された症例,糖尿病非関連発見群:糖尿病関連以外で発見された症例,の2群に分け,膵癌診断時の症状,HbA1c,各種腫瘍マーカー,外科的切除率について比較検討した.【結果】糖尿病関連発見群では32.4%,糖尿病非関連発見群では100%で有症状であった.各種腫瘍マーカーは両群で有意差はなかったがいずれも高値で,HbA1c(10.0±1.9% vs 8.6±2.1%,p=0.006),外科的切除率は糖尿病関連発見群で有意に高かった.【結論】糖尿病症例において,症状が軽度であってもHbA1c値が10%以上,腫瘍マーカーが高値の場合には各種画像検査を行うことで,より早期での膵癌の診断が可能となると考えられた.<br>

OBJECTIVE: We conducted a retrospective investigation to establish efficient screening for pancreatic cancer in patients with diabetes.<br> METHOD: Of 287 pancreatic cancer patients, 68 patients who already had underlying diabetes at the time of diagnosis of the pancreatic cancer were included in this study. These 68 patients were divided into two groups: Diabetes-related diagnosed group (Group 1), in which the pancreatic cancer was detected by diagnostic imaging at the time of worsening of diabetes, and the Diabetes-non-related diagnosed group (Group 2), in which the pancreatic cancer was diagnosed independently from diabetes. Clinical factors were compared between in the two groups.<br> RESULTS: There were 34 cases in the Group 1 and 34 cases in the Group 2. There were no significant differences in the levels of symptoms, tumor markers, or tumor size between two groups. Mean HbA1c was significantly higher in the Group 1 (10.0±1.9% vs. 8.6±2.1%, p=0.006). The surgical resection rate was also significantly higher in the Group 1 (41.1% vs. 18.0%, p=0.02).<br> CONCLUSION: Intensive examination such as diagnostic imaging might be effective for early detection of pancreatic cancer in diabetic patients with elevated HbA1c greater than 10%.<br>

収録刊行物

  • 膵臓 = The Journal of Japan Pancreas Society

    膵臓 = The Journal of Japan Pancreas Society 27(2), 153-157, 2012-04-25

    Japan Pancreas Society

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各種コード

  • NII論文ID(NAID)
    10030764067
  • NII書誌ID(NCID)
    AN10043798
  • 本文言語コード
    JPN
  • 資料種別
    REV
  • ISSN
    09130071
  • データ提供元
    CJP書誌  CJP引用  J-STAGE 
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