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05-07-2022 | Metastasis | Original Article

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

Authors: Pin Zhang, Zhiwen Xiao, Huaxiang Xu, Xinzhe Zhu, Lei Wang, Dan Huang, Yun Liang, Quanxing Ni, Jie Chen, Xianjun Yu, Guopei Luo

Published in: Endocrine | Issue 2/2022

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.

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Title: Hyperglycemia is associated with adverse prognosis in patients with pancreatic neuroendocrine neoplasms
Authors: Pin Zhang
Zhiwen Xiao
Huaxiang Xu
Xinzhe Zhu
Lei Wang
Dan Huang
Yun Liang
Quanxing Ni
Jie Chen
Xianjun Yu
Guopei Luo
Publication date: 05-07-2022
Publisher: Springer US
Keywords: Metastasis
Hyperglycemia
Diabetes
Neuroendocrine Tumor
Published in: Endocrine / Issue 2/2022
Print ISSN: 1355-008X
Electronic ISSN: 1559-0100
DOI: https://doi.org/10.1007/s12020-022-03100-0

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