Hyperglycemia is associated with adverse prognosis in patients with pancreatic neuroendocrine neoplasms

Pin Zhang^#^{1

2

3

4

5}, Zhiwen Xiao^#^{1

2

3

4

5}, Huaxiang Xu^#^{1

2

3

4

5}, Xinzhe Zhu^{1

2

3

4

5}, Lei Wang^{2

6}, Dan Huang^{2

6}, Yun Liang^{1

2

7}, Quanxing Ni^{1

2

3

4

5}, Jie Chen^{1

2

7}, Xianjun Yu^{8

9

10

11

12}, Guopei Luo^{13

14

15

16

17}

Affiliations

¹ Center for Neuroendocrine Tumors, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
² Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
³ Pancreatic Cancer Institute, Fudan University, Shanghai, 200032, China.
⁴ Shanghai Pancreatic Cancer Institute, Shanghai, 200032, China.
⁵ Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
⁶ Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
⁷ Department of Head & Neck tumors and Neuroendocrine Tumors, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
⁸ Center for Neuroendocrine Tumors, Fudan University Shanghai Cancer Center, Shanghai, 200032, China. yuxianjun@fudanpci.org.
⁹ Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China. yuxianjun@fudanpci.org.
¹⁰ Pancreatic Cancer Institute, Fudan University, Shanghai, 200032, China. yuxianjun@fudanpci.org.
¹¹ Shanghai Pancreatic Cancer Institute, Shanghai, 200032, China. yuxianjun@fudanpci.org.
¹² Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China. yuxianjun@fudanpci.org.
¹³ Center for Neuroendocrine Tumors, Fudan University Shanghai Cancer Center, Shanghai, 200032, China. luoguopei@fudnapci.org.
¹⁴ Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China. luoguopei@fudnapci.org.
¹⁵ Pancreatic Cancer Institute, Fudan University, Shanghai, 200032, China. luoguopei@fudnapci.org.
¹⁶ Shanghai Pancreatic Cancer Institute, Shanghai, 200032, China. luoguopei@fudnapci.org.
¹⁷ Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China. luoguopei@fudnapci.org.

^# Contributed equally.

PMID: 35790660
DOI: 10.1007/s12020-022-03100-0

Hyperglycemia is associated with adverse prognosis in patients with pancreatic neuroendocrine neoplasms

Pin Zhang et al. Endocrine. 2022 Aug.

. 2022 Aug;77(2):262-271.

doi: 10.1007/s12020-022-03100-0. Epub 2022 Jul 5.

Authors

Affiliations

¹ Center for Neuroendocrine Tumors, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
² Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
³ Pancreatic Cancer Institute, Fudan University, Shanghai, 200032, China.
⁴ Shanghai Pancreatic Cancer Institute, Shanghai, 200032, China.
⁵ Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
⁶ Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
⁷ Department of Head & Neck tumors and Neuroendocrine Tumors, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
⁸ Center for Neuroendocrine Tumors, Fudan University Shanghai Cancer Center, Shanghai, 200032, China. yuxianjun@fudanpci.org.
⁹ Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China. yuxianjun@fudanpci.org.
¹⁰ Pancreatic Cancer Institute, Fudan University, Shanghai, 200032, China. yuxianjun@fudanpci.org.
¹¹ Shanghai Pancreatic Cancer Institute, Shanghai, 200032, China. yuxianjun@fudanpci.org.
¹² Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China. yuxianjun@fudanpci.org.
¹³ Center for Neuroendocrine Tumors, Fudan University Shanghai Cancer Center, Shanghai, 200032, China. luoguopei@fudnapci.org.
¹⁴ Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China. luoguopei@fudnapci.org.
¹⁵ Pancreatic Cancer Institute, Fudan University, Shanghai, 200032, China. luoguopei@fudnapci.org.
¹⁶ Shanghai Pancreatic Cancer Institute, Shanghai, 200032, China. luoguopei@fudnapci.org.
¹⁷ Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China. luoguopei@fudnapci.org.

^# Contributed equally.

PMID: 35790660
DOI: 10.1007/s12020-022-03100-0

Abstract

Background: Although glucose has a well-recognized protumoral role and the pancreas is a critical organ in adjusting glucose metabolism, the clinical value of hyperglycemia in pancreatic neuroendocrine neoplasms (pNENs) remains largely unidentified.

Methods: A retrospective study including 335 patients with pathologically confirmed pNENs was conducted. A baseline fasting blood glucose concentration ≥5.6 mmol/L was defined as hyperglycemia (otherwise, normal). Survival and regression analyses were performed.

Results: Compared with patients with normal glucose, patients with hyperglycemia (47.8%) had a higher proportion of preexisting diabetes mellitus (DM) (36.9% vs. 4.6%, p < 0.001), lymph node involvement (31.0% vs. 14.6%, p = 0.002), distant metastasis (34.4% vs. 22.9%, p = 0.019), and carbohydrate antigen 19-9 (CA19-9) ≥ 37 U/mL (16.6% vs. 7.2%, p = 0.009). Hyperglycemia was associated with CA19-9 ≥ 37 U/mL (Odds Ratio (OR) = 3.19, 95% CI: 1.11-9.17, p = 0.031), lymph node involvement (OR = 2.32, 95% CI: 1.02-5.28, p = 0.045), nonfunctional tumors (OR = 9.90, 95% CI: 2.11-46.34, p = 0.004), and preexisting diabetes (OR = 18.24, 95% CI: 4.06-81.95, p < 0.001). Hyperglycemia was an independent determinant for overall survival in the multivariate analysis (hazard ratio (HR) = 2.65, 95% CI: 1.31-5.34, p = 0.006).

Conclusion: Hyperglycemia is an independent predictor of overall survival and is associated with preexisting DM or lymphatic metastasis in patients with pNENs. Patients with hyperglycemia and resectable pNENs may benefit from radical resection with dissection of regional lymph nodes.

Keywords: CA19-9; Diabetes mellitus; Impaired glucose tolerance; Lymph node metastasis; Pancreatic neuroendocrine tumor; Prediabetes.

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References

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Hyperglycemia is associated with adverse prognosis in patients with pancreatic neuroendocrine neoplasms

Affiliations

Hyperglycemia is associated with adverse prognosis in patients with pancreatic neuroendocrine neoplasms

Authors

Affiliations

Abstract

References

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LinkOut - more resources

Full Text Sources

Medical