PO.CL09.02 · 临床研究
胰腺癌化疗反应的代谢预测因子
Metabolic predictors of chemotherapy response in pancreatic cancer
作者与单位 Authors & Affiliations
摘要 Abstract
中文摘要
引言：胰腺癌（PC）的化疗反应存在差异，通常通过CA 19-9进行监测。由于PC与代谢失调相关，本研究评估非手术PC患者的基线代谢状态（血糖、HbA1c和BMI）与六个月内CA 19-9纵向变化趋势的关系。
方法：采用基于TriNetX的研究设计，分析未接受手术干预的PC患者六个月内（代表最佳化疗反应窗口）CA 19-9的纵向变化趋势。患者根据以下指标被划分为不同层：（1）血糖水平：<150 mg/dL、150-250 mg/dL、251-350 mg/dL；（2）HbA1c水平：<7%、7-10%、10%-13.5%；以及（3）BMI范围：20-25、25-30、30-35、35-40。
结果：血糖方面：基线CA 19-9水平与血糖分层的升高呈正相关。仅最高血糖组（251-350 mg/dL）在化疗期间显示出具有统计学意义的CA 19-9下降（p<0.05）。将该组与两个较低组比较时均出现显著差异（p<0.05）。在各疾病分期中，较高的血糖水平始终与更大幅度的CA 19-9下降相关，提示化疗反应增强。这种关联在局部晚期（2、3期）中最为显著。HbA1c方面：高HbA1c组（10%-13.5%）的基线CA 19-9值较低。虽然组内下降不显著，但六个月时的组间比较表明，最高HbA1c组与<7%组和7-10%组相比，CA 19-9下降幅度显著更大（p<0.05）。BMI方面：各组间基线CA 19-9水平无差异。治疗期间，仅最高BMI组（35-40）表现出显著的CA 19-9下降（p<0.05），而较低BMI组（20-35）则无。BMI为35-40的患者相比较低BMI类别反应更佳（p<0.05）。
结论：本研究表明，基线代谢因素调节非手术PC患者的化疗反应。较高的血糖和BMI以及升高的HbA1c与化疗期间更大幅度的CA 19-9下降相关，提示代谢状态可能影响治疗疗效。这些发现凸显了进一步研究和支持性代谢干预以优化胰腺癌化疗结局的必要性。
查看英文原文 English abstract
INTRODUCTION: Chemotherapy response in pancreatic cancer (PC) varies and is monitored by CA 19-9. Since PC is linked to metabolic dysregulation, this study evaluates how patient baseline metabolic status (glucose, HbA1c, and BMI) relates to the longitudinal trend of CA 19-9 over six months in non-surgical PC patients.
METHODS: A TriNetX-based study design was employed to analyze longitudinal CA 19-9 trends over six months (representing the optimal chemotherapy response window) in PC patients who did not undergo surgical intervention. Patients were categorized into distinct strata based on (1) glucose levels: <150 mg/dL, 150-250 mg/dL, 251-350 mg/dL; (2) HbA1c levels: <7%, 7-10%, 10%-13.5%; and (3) BMI ranges: 20-25, 25-30, 30-35, 35-40.
RESULTS: For Glucose: Baseline CA 19-9 levels correlated positively with increasing glucose strata. Only the highest glucose group (251-350 mg/dL) showed a statistically significant CA 19-9 reduction during chemotherapy (p<0.05). Significant differences emerged when comparing this group to both lower groups (p<0.05). Across disease stages, higher glucose levels were consistently associated with greater CA 19-9 declines, indicating enhanced chemotherapy response. This association was most pronounced in locally advanced stages (2,3). For HbA1c: Baseline CA 19-9 values were lower in the high HbA1c group (10%-13.5%). Although within-group declines were not significant, between-group comparisons at six months indicated a significantly greater CA 19-9 reduction in the highest HbA1c group compared with both the <7% and 7-10% groups (p<0.05). For BMI: Baseline CA 19-9 levels did not differ across groups. During treatment, only the highest BMI group (35-40) demonstrated a significant decline in CA 19-9 (p<0.05), while lower BMI groups (20-35) did not. Patients with BMI 35-40 responded more favorably compared with lower BMI categories (p<0.05).
CONCLUSION: This study demonstrates that baseline metabolic factors modulate chemotherapy response in non-surgical PC patients. Higher glucose and BMI, as well as elevated HbA1c, were associated with greater CA 19-9 declines during chemotherapy, suggesting that metabolic status may influence treatment efficacy. These findings highlight the need for further studies and supportive metabolic interventions to optimize chemotherapy outcomes in pancreatic cancer.
利益披露 Disclosure
P. Naji, None..
J. Winter, None.