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. 2020 Jan 1;11(4):867-873.
doi: 10.7150/jca.34843. eCollection 2020.

Interaction between fasting blood glucose and tumor embolus in predicting the postoperative prognosis of 4330 Chinese patients with gastrointestinal tract cancer

Dan Hu  1 , Xinran Zhang  2 , Xiandong Lin  3 , Hejun Zhang  1 , Yan Xia  1 , Jinxiu Lin  4 , Xiongwei Zheng  1 , Feng Peng  4 , Wenquan Niu  2
Affiliations

Interaction between fasting blood glucose and tumor embolus in predicting the postoperative prognosis of 4330 Chinese patients with gastrointestinal tract cancer

Dan Hu et al. J Cancer. .

Abstract

Objectives: We aimed to investigate the interaction between fasting blood glucose and tumor embolus, and the potential mediation effect of fasting blood glucose on tumor embolus in predicting gastrointestinal tract cancer-specific mortality risk postoperatively. Methods and Results: 4330 patients were consecutively recruited between January 2000 and December 2010, with annual follow-up ending in December 2015. The median follow-up time was 48.6 months. Two optimal cutoff points for fasting blood glucose (6.11 and 11.69 mmol/L) were identified. Patients with fasting blood glucose <6.11 mmol/L and negative tumor embolus had the best survival, and the worst survival was seen in patients with fasting blood glucose >11.69 mmol/L and positive tumor embolus. The risk was highest for patients with fasting blood glucose >11.69 mmol/L and positive tumor embolus (adjusted HR: 11.91, 95% CI: 9.13 to 15.52). Using the Sobel-Goodman mediation test, the proportion of total effect conferred by tumor embolus that was mediated by fasting blood glucose was estimated to be 45.3%. Conclusions: Our findings indicate a synergistic interaction between fasting blood glucose and tumor embolus in predicting the postoperative prognosis of gastrointestinal tract cancer.

Keywords: fasting blood glucose; gastrointestinal tract cancer; interaction; mortality; prognosis; tumor embolus.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interest exists.

Figures

Figure 1
Figure 1
Kaplan-Meier survival curve per fasting glucose (in three groups) and tumor embolus in combination (upper panel), and association between fasting glucose and cancer-specific mortality risk (lower panel) among patients with gastrointestinal tract cancer. In lower panel, navy line was plotted for positive embolus, and blue line for negative embolus. Dotted lines represent 95% confidence intervals.
Figure 2
Figure 2
Risk estimation of fasting blood glucose and tumor embolus in combination for gastrointestinal tract cancer-specific mortality. The unit for fasting blood glucose is mmol/L. All risk estimates were significant at a level of 0.001.
See this image and copyright information in PMC

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