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Publications (10 of 23) Show all publications
Sugawara, T., Rodriguez Franco, S., Sherman, S., Torphy, R. J., Colborn, K., Franklin, O., . . . Del Chiaro, M. (2024). Neoadjuvant chemotherapy versus upfront surgery for resectable pancreatic adenocarcinoma: an updated nationwide study. Annals of Surgery, 279(2), 331-339
Open this publication in new window or tab >>Neoadjuvant chemotherapy versus upfront surgery for resectable pancreatic adenocarcinoma: an updated nationwide study
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2024 (English)In: Annals of Surgery, ISSN 0003-4932, E-ISSN 1528-1140, Vol. 279, no 2, p. 331-339Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: The objective of this study was to assess the association of survival with neoadjuvant chemotherapy (NAC) in resectable pancreatic adenocarcinoma (PDAC). B

ACKGROUND: The early control of potential micrometastases and patient selection using NAC has been advocated for patients with PDAC. However, the role of NAC for resectable PDAC remains unclear.

METHODS: Patients with clinical T1 and T2 PDAC were identified in the National Cancer Database from 2010 to 2017. Kaplan-Meier estimates, and Cox regression models were used to compare survival. To address immortal time bias, landmark analysis was performed. Interactions between preoperative factors and NAC were investigated in subgroup analyses. A propensity score analysis was performed to compare survival between multiagent NAC and upfront surgery.

RESULTS: In total, 4041 patients were treated with upfront surgery and 1,175 patients were treated with NAC (79.4% multiagent NAC, 20.6% single-agent NAC). Using a landmark time of 6 months after diagnosis, patients treated with multiagent NAC had longer median overall survival compared with upfront surgery and single-agent NAC. (35.8 vs 27.1 vs 27.4 mo). Multiagent NAC was associated with lower mortality rates compared with upfront surgery (adjusted hazard ratio, 0.77; 95% CI, 0.70-0.85), whereas single-agent NAC was not. The association of survival with multiagent NAC were consistent in analyses using the matched data sets. Interaction analysis revealed that the association between multiagent NAC and a lower mortality rate did not significantly differ across age, facility type, tumor location, CA 19-9 levels, and clinical T/N stages.

CONCLUSIONS: The findings suggest that multiagent NAC followed by resection is associated with improved survival compared with upfront surgery.

Place, publisher, year, edition, pages
Wolters Kluwer, 2024
Keywords
pancreatic adenocarcinoma, resectable, neoadjuvant chemotherapy, multiagent, single-agent
National Category
Gastroenterology and Hepatology Cancer and Oncology
Identifiers
urn:nbn:se:umu:diva-219815 (URN)10.1097/SLA.0000000000005925 (DOI)37226812 (PubMedID)2-s2.0-85182091267 (Scopus ID)
Funder
Swedish Society of Medicine, SLS-934237Region Västerbotten, RV 967602NIH (National Institutes of Health)
Available from: 2024-01-23 Created: 2024-01-23 Last updated: 2024-02-01Bibliographically approved
Lidström, T., Cumming, J., Gaur, R., Frängsmyr, L., Pateras, I., Mickert, M. J., . . . Öhlund, D. (2023). Extracellular galectin 4 drives immune evasion and promotes T-cell apoptosis in pancreatic cancer. Cancer immunology research, 11(1), 72-92
Open this publication in new window or tab >>Extracellular galectin 4 drives immune evasion and promotes T-cell apoptosis in pancreatic cancer
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2023 (English)In: Cancer immunology research, ISSN 2326-6066, Vol. 11, no 1, p. 72-92Article in journal (Refereed) Published
Abstract [en]

Pancreatic ductal adenocarcinoma (PDAC) is characterized by rich deposits of extracellular matrix (ECM), affecting the pathophysiology of the disease. Here, we identified galectin 4 (gal 4) as a cancer cell produced protein deposited into the ECM of PDAC tumors and detected high circulating levels of gal 4 in PDAC patients. In orthotopic transplantation experiments we observed increased infiltration of T-cells and prolonged survival in immunocompetent mice transplanted with cancer cells with reduced expression of gal 4. Increased survival was not observed in immunodeficient RAG1-/- mice, demonstrating that the effect was mediated by the adaptive immune system. Furthermore, by performing single-cell RNA-sequencing we found that the myeloid compartment and cancer-associated fibroblast (CAF) subtypes were altered in the transplanted tumors. Reduced gal 4 expression was associated with higher proportion of myofibroblastic CAFs and reduced numbers of inflammatory CAFs. We also found higher proportions of M1 macrophages, T-cells and antigen presenting dendritic cells in tumors with reduced gal 4 expression. Using a co-culture system, we observed that extracellular gal 4 induced apoptosis in T-cells by binding N-glycosylation residues on CD3 epsilon/delta. Hence, we show that gal 4 is involved in immune evasion and identify gal 4 as a promising drug target for overcoming immunosuppression in PDAC. 

Place, publisher, year, edition, pages
American Association for Cancer Research, 2023
Keywords
Galectin 4, pancreatic cancer, immunosuppression, extracellular matrix, drug target
National Category
Cancer and Oncology
Research subject
Immunology; Medicine; Oncology
Identifiers
urn:nbn:se:umu:diva-201042 (URN)10.1158/2326-6066.CIR-21-1088 (DOI)36478037 (PubMedID)2-s2.0-85145492684 (Scopus ID)
Funder
The Swedish Foundation for International Cooperation in Research and Higher Education (STINT), PT2015-6432Swedish Cancer Society, AMP17-877, LP18-2202, LP20-2257, LP 21-2298Swedish Research Council, 2017-01531The Kempe Foundations, JCK-1301, SMK-1765Swedish Society of Medicine, SLS-890521, SLS-786661, SLS-691681, SLS-591551Västerbotten County Council, RV-930167, VLL-643451, VLL-832001Sjöberg FoundationKnut and Alice Wallenberg FoundationMarianne and Marcus Wallenberg Foundation, MMW 2020.0189Swedish Cancer Society, CAN 2017/332, CAN 2017/827, 20 1339 PjFSwedish Cancer Society, AMP-18-919Knut and Alice Wallenberg Foundation
Note

Originally included in thesis in manuscript form. 

Available from: 2022-11-16 Created: 2022-11-16 Last updated: 2023-10-18Bibliographically approved
Sugawara, T., Rodriguez Franco, S., Franklin, O., Kirsch, M. J., Colborn, K. L., Del Chiaro, M. & Schulick, R. D. (2023). Management of localized small- and large-cell pancreatic neuroendocrine carcinoma in the national cancer database. Journal of the American College of Surgeons, 237(3), 515-524
Open this publication in new window or tab >>Management of localized small- and large-cell pancreatic neuroendocrine carcinoma in the national cancer database
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2023 (English)In: Journal of the American College of Surgeons, ISSN 1072-7515, E-ISSN 1879-1190, Vol. 237, no 3, p. 515-524Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The role of curative-intent resection and perioperative chemotherapy for nonmetastatic pancreatic neuroendocrine carcinoma (PanNEC) remains unclear due to their biological aggressiveness and rarity. This study aimed to evaluate the association of resection and perioperative chemotherapy with overall survival for nonmetastatic PanNEC.

STUDY DESIGN: Patients with localized (cT1-3, M0), small- and large-cell PanNEC were identified in the National Cancer Database from 2004 to 2017. The changing trends in terms of the annual proportions of resection and adjuvant chemotherapy were assessed. The survival of patients who received resection and those who received adjuvant chemotherapy were investigated using Kaplan-Meier estimates and Cox regression models.

RESULTS: In total, 199 patients with localized small- and large-cell PanNEC were identified; 50.3% of those were resected, and 45.0% of the resected patients received adjuvant chemotherapy. Rate of resection and adjuvant treatment has trended upward since 2011. The resected group was younger, was more often treated at academic institutions, had more distal tumors, and had a lower number of small-cell PanNEC. The median overall survival was longer in the resected group compared to the unresected group (29.4 months vs 8.6 months, p < 0.001). Resection was associated with improved survival in a multivariable Cox regression model adjusting for preoperative factors (adjusted hazard ratio 0.58, 95% CI 0.37 to 0.92), while adjuvant therapy was not.

CONCLUSIONS: This nationwide retrospective study suggests that resection is associated with improved survival in patients with localized PanNEC. The role of adjuvant chemotherapy needs more investigation.

Place, publisher, year, edition, pages
Wolters Kluwer, 2023
National Category
Cancer and Oncology Surgery
Identifiers
urn:nbn:se:umu:diva-218673 (URN)10.1097/XCS.0000000000000735 (DOI)001049960200017 ()37146214 (PubMedID)2-s2.0-85179853235 (Scopus ID)
Available from: 2023-12-27 Created: 2023-12-27 Last updated: 2024-02-01Bibliographically approved
Molnár, A., Halimi, A., Svensson, J., Bayadsi, H., Innala, M., Hansén, M., . . . Franklin, O. (2023). Portomesenteric venous contact ≤180° and overall survival in resectable head and body pancreatic adenocarcinoma treated with upfront surgery. European Journal of Surgical Oncology, 49(11), Article ID 107097.
Open this publication in new window or tab >>Portomesenteric venous contact ≤180° and overall survival in resectable head and body pancreatic adenocarcinoma treated with upfront surgery
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2023 (English)In: European Journal of Surgical Oncology, ISSN 0748-7983, E-ISSN 1532-2157, Vol. 49, no 11, article id 107097Article in journal (Refereed) Published
Abstract [en]

Introduction: Upfront surgery is the standard of care for resectable pancreatic cancer, defined as the absence of or ≤180° tumour contact with the portal/superior mesenteric vein. We hypothesized that portomesenteric venous contact is prognostically unfavourable and aimed to assess whether it is associated with poorer outcomes compared with no venous contact in resectable head and body pancreatic cancer.

Methods: This single-centre retrospective study included patients undergoing upfront surgery for resectable head and body pancreatic cancer in 2010–2020 at Umeå University Hospital, Sweden. No venous contact was compared with portomesenteric venous contact of ≤180° based on preoperative imaging. Survival on an intention-to-treat basis was compared with Kaplan-Meier curves, a log-rank test and Cox proportional hazards models.

Results: The final study cohort included 39 patients with portomesenteric venous contact and 144 patients without venous contact. Patients with portomesenteric tumour contact had a median overall survival of 15.3 months compared to 23.0 months (log rank P = 0.059). Portomesenteric venous contact was an independent negative prognostic factor for survival in the multivariable Cox model (HR 1.68; 95% CI 1.11–2.55, P = 0.014) and was associated with higher rates of microscopically non-radical resections (R1) (50% vs 26.1%, P = 0.012) and pathological lymph node metastasis (76.7% vs 56.8%, P = 0.012). There was no difference in adjuvant chemotherapy receipt or postoperative complications between the groups.

Conclusions: Portomesenteric venous contact is associated with poorer overall survival and higher rates of R1 resections and lymph node metastasis in patients with resectable head and body pancreatic cancer treated with upfront surgery.

Place, publisher, year, edition, pages
Elsevier, 2023
Keywords
Pancreatic adenocarcinoma
National Category
Surgery
Research subject
Surgery
Identifiers
urn:nbn:se:umu:diva-214812 (URN)10.1016/j.ejso.2023.107097 (DOI)37804583 (PubMedID)2-s2.0-85173010733 (Scopus ID)
Funder
Umeå University, AMP 23-1127Region Västerbotten, RV-979958Swedish Society of Medicine, SLS-960379The Royal Swedish Academy of Sciences, LM2021-0010Region Västerbotten, RV-982574Region Västerbotten, RV--982481Bengt Ihres Foundation, SLS-960529Knut and Alice Wallenberg Foundation, RV-769711
Available from: 2023-10-02 Created: 2023-10-02 Last updated: 2024-02-01Bibliographically approved
Mason, J. E., Lundberg, E., Jonsson, P., Nyström, H., Franklin, O., Lundin, C., . . . Öhlund, D. (2022). A cross-sectional and longitudinal analysis of pre-diagnostic blood plasma biomarkers for early detection of pancreatic cancer. International Journal of Molecular Sciences, 23(21), Article ID 12969.
Open this publication in new window or tab >>A cross-sectional and longitudinal analysis of pre-diagnostic blood plasma biomarkers for early detection of pancreatic cancer
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2022 (English)In: International Journal of Molecular Sciences, ISSN 1661-6596, E-ISSN 1422-0067, Vol. 23, no 21, article id 12969Article in journal (Refereed) Published
Abstract [en]

Pancreatic ductal adenocarcinoma (PDAC) is a major cause of cancer death that typically presents at an advanced stage. No reliable markers for early detection presently exist. The prominent tumor stroma represents a source of circulating biomarkers for use together with cancer cell-derived biomarkers for earlier PDAC diagnosis. CA19-9 and CEA (cancer cell-derived biomarkers), together with endostatin and collagen IV (stroma-derived) were examined alone, or together, by multivariable modelling, using pre-diagnostic plasma samples (n = 259 samples) from the Northern Sweden Health and Disease Study biobank. Serial samples were available for a subgroup of future patients. Marker efficacy for future PDAC case prediction (n = 154 future cases) was examined by both cross-sectional (ROC analysis) and longitudinal analyses. CA19-9 performed well at, and within, six months to diagnosis and multivariable modelling was not superior to CA19-9 alone in cross-sectional analysis. Within six months to diagnosis, CA19-9 (AUC = 0.92) outperformed the multivariable model (AUC = 0.81) at a cross-sectional level. At diagnosis, CA19-9 (AUC = 0.995) and the model (AUC = 0.977) performed similarly. Longitudinal analysis revealed increases in CA19-9 up to two years to diagnosis which indicates a window of opportunity for early detection of PDAC.

Place, publisher, year, edition, pages
MDPI, 2022
Keywords
analysis, biomarkers, carcinoma, early detection of cancer, pancreatic ductal, tumor, tumor microenvironment
National Category
Cancer and Oncology
Research subject
Surgery
Identifiers
urn:nbn:se:umu:diva-201220 (URN)10.3390/ijms232112969 (DOI)000881359700001 ()36361759 (PubMedID)2-s2.0-85141870302 (Scopus ID)
Funder
Swedish Research Council, 2017-01531Swedish Research Council, 2016-02990Swedish Research Council, 2019-01690Swedish Research Council, 2017-00650The Kempe Foundations, JCK-1301Swedish Society of Medicine, SLS-890521Swedish Society of Medicine, SLS-786661Region Västerbotten, RV-930167Västerbotten County Council, VLL-643451Västerbotten County Council, VLL-832001Region Västerbotten, RV-583411Region Västerbotten, RV-549731Region Västerbotten, RV-841551Region Västerbotten, 930132Region Västerbotten, RV-930167Cancerforskningsfonden i Norrland, LP20-2257Cancerforskningsfonden i Norrland, LP18-2202Cancerforskningsfonden i Norrland, LP18-2192Cancerforskningsfonden i Norrland, LP21-2298Cancerforskningsfonden i Norrland, LP22-2332Sjöberg FoundationKnut and Alice Wallenberg Foundation, KAW 2015.0114Marianne and Marcus Wallenberg Foundation, MMW 2020.0189Swedish Cancer Society, CAN 2017/332Swedish Cancer Society, CAN 2017/827Swedish Cancer Society, CAN 2011/751Swedish Cancer Society, CAN 2016/643Swedish Cancer Society, 19 0273Swedish Cancer Society, 20 1339
Available from: 2022-12-15 Created: 2022-12-15 Last updated: 2023-06-08Bibliographically approved
Cayssials, V., Buckland, G., Crous-Bou, M., Bonet, C., Weiderpass, E., Skie, G., . . . Jakszyn, P. (2022). Inflammatory potential of diet and pancreatic cancer risk in the EPIC study. European Journal of Nutrition, 61, 2313-2320
Open this publication in new window or tab >>Inflammatory potential of diet and pancreatic cancer risk in the EPIC study
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2022 (English)In: European Journal of Nutrition, ISSN 1436-6207, E-ISSN 1436-6215, Vol. 61, p. 2313-2320Article in journal (Refereed) Published
Abstract [en]

Purpose: There is existing evidence on the potential role of chronic inflammation in the pathogenesis of pancreatic cancer (PC) and on how risk may be modulated by dietary factors. Pro-inflammatory diets are suggested to be associated with increased risk of PC but, so far, evidence remains not conclusive. We examined the association between the dietary inflammatory potential and PC risk within the European Prospective Investigation into Cancer and Nutrition (EPIC) study, which includes 450,112 participants.

Methods: After a 14-year follow-up, a total of 1239 incident PC cases were included in this study. The inflammatory potential of the diet was estimated using an Inflammatory Score of the Diet (ISD). Hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between the ISD and PC were estimated using multivariable Cox regression models, adjusted for known risk factors for PC.

Results: Participants with higher ISDs had a higher risk of developing PCs. In the fully adjusted multivariate model, the risk of PC increased by 11% (HR 1.11, 95% CI 1.02–1.22) for 1 point each standard deviation increase in the ISD score. Neither obesity nor any other known risk factor for PC showed statistically significant interactions.

Conclusion: To the best of our knowledge, this is the first prospective study reporting a positive relationship between the inflammatory potential of diet and PC. Since early diagnosis and treatment of pancreatic cancer might be challenging, prevention remains the major hope for reducing the burden of this disease.

Place, publisher, year, edition, pages
Springer Nature, 2022
Keywords
Dietary patterns, Epidemiology, Inflammatory potential of diet, Pancreatic cancer, Prospective cohort
National Category
Nutrition and Dietetics
Research subject
Surgery
Identifiers
urn:nbn:se:umu:diva-192264 (URN)10.1007/s00394-022-02809-y (DOI)000750865700001 ()35091827 (PubMedID)2-s2.0-85123866321 (Scopus ID)
Available from: 2022-03-11 Created: 2022-03-11 Last updated: 2023-06-08Bibliographically approved
Katzke, V. A., Le Cornet, C., Mahfouz, R., Brauer, B., Johnson, T., Canzian, F., . . . Kaaks, R. (2021). Are Circulating Immune Cells a Determinant of Pancreatic Cancer Risk? A Prospective Study Using Epigenetic Cell Count Measures. Cancer Epidemiology, Biomarkers and Prevention, 30(12), 2179-2187
Open this publication in new window or tab >>Are Circulating Immune Cells a Determinant of Pancreatic Cancer Risk? A Prospective Study Using Epigenetic Cell Count Measures
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2021 (English)In: Cancer Epidemiology, Biomarkers and Prevention, ISSN 1055-9965, E-ISSN 1538-7755, Vol. 30, no 12, p. 2179-2187Article in journal (Refereed) Published
Abstract [en]

Background: Evidence is accumulating that immune cells play a prominent role in pancreatic cancer etiology but prospective investigations are missing.

Methods: We conducted a nested case–control study within the European Prospective Investigation into Cancer and Nutrition (EPIC) study with 502 pairs of incident pancreatic cancer cases and matched controls. Relative counts of circulating immune cells (neutrophils and lymphocyte sublineages: total CD3+, CD8+, CD4+, and FOXP3+ regulatory T cells (Tregs) relative to nucleated cells, (white blood cells) were measured by qRT-PCR. ORs with 95% confidence intervals were estimated using logistic regressions, modeling relative counts of immune cells on a continuous scale.

Results: Neither relative counts of immune cell types taken individually, nor mutually adjusted for each other were associated with pancreatic cancer risks. However, in subgroup analyses by strata of lag-time, higher relative counts of Tregs and lower relative counts of CD8+ were significantly associated with an increased pancreatic cancer risks in participants diagnosed within the first 5 years of follow-up.

Conclusions: These results might reflect reverse causation, due to higher relative counts of Tregs and lower counts of CD8+ cells among individuals with more advanced stages of latent pancreatic cancer, who are closer to the point of developing clinical manifest disease.

Impact: We have shown, for the first time, that increased relative counts of regulatory T cells and lower relative counts of CD8+, cytotoxic T cells may be associated with pancreatic cancer risk or relatively late-stage tumor development. See related commentary by Michaud and Kelsey, p. 2176

Place, publisher, year, edition, pages
American Association for Cancer Research (AACR), 2021
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:umu:diva-190963 (URN)10.1158/1055-9965.EPI-21-0169 (DOI)000728161100001 ()34548327 (PubMedID)2-s2.0-85121693953 (Scopus ID)
Available from: 2022-01-04 Created: 2022-01-04 Last updated: 2023-03-24Bibliographically approved
Borgmästars, E., Lundberg, E., Öhlund, D., Nyström, H., Franklin, O., Lundin, C., . . . Sund, M. (2021). Circulating tissue polypeptide-specific antigen in pre-diagnostic pancreatic cancer samples. Cancers, 13(21), Article ID 5321.
Open this publication in new window or tab >>Circulating tissue polypeptide-specific antigen in pre-diagnostic pancreatic cancer samples
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2021 (English)In: Cancers, ISSN 2072-6694, Vol. 13, no 21, article id 5321Article in journal (Refereed) Published
Abstract [en]

Early detection of pancreatic ductal adenocarcinoma (PDAC) is challenging, and late diagnosis partly explains the low 5-year survival. Novel and sensitive biomarkers are needed to enable early PDAC detection and improve patient outcomes. Tissue polypeptide specific antigen (TPS) has been studied as a biomarker in PDAC diagnostics, and it has previously been shown to reflect clinical status better than the ‘golden standard’ biomarker carbohydrate antigen 19-9 (CA 19-9) that is most widely used in the clinical setting. In this cross-sectional case-control study using pre-diagnostic plasma samples, we aim to evaluate the potential of TPS as a biomarker for early PDAC detection. Furthermore, in a subset of individuals with multiple samples available at different time points before diagnosis, a longitudinal analysis was used. We assessed plasma TPS levels using enzyme-linked immunosorbent assay (ELISA) in 267 pre-diagnostic PDAC plasma samples taken up to 18.8 years before clinical PDAC diagnosis and in 320 matched healthy controls. TPS levels were also assessed in 25 samples at PDAC diagnosis. Circulating TPS levels were low both in pre-diagnostic samples of future PDAC patients and in healthy controls, whereas TPS levels at PDAC diagnosis were significantly increased (odds ratio 1.03; 95% confidence interval: 1.01–1.05) in a logistic regression model adjusted for age. In conclusion, TPS levels increase late in PDAC progression and hold no potential as a biomarker for early detection.

Place, publisher, year, edition, pages
MDPI, 2021
Keywords
Circulating biomarkers, Early detection, Pancreatic ductal adenocarcinoma, Pre-diagnostic cohort, TPS
National Category
Cancer and Oncology Gastroenterology and Hepatology
Identifiers
urn:nbn:se:umu:diva-188952 (URN)10.3390/cancers13215321 (DOI)000720278600001 ()2-s2.0-85117441860 (Scopus ID)
Funder
Region VästerbottenSjöberg FoundationSwedish Cancer Society, 19 0273, 2017-557, CAN 2017/332, CAN 2017/827Knut and Alice Wallenberg Foundation, RV-549731, RV-583411, RV-841551, RV-930167, VLL-643451Swedish Research Council, 2016-02990, 2017-01531, 2019-01690
Available from: 2021-10-29 Created: 2021-10-29 Last updated: 2023-09-05Bibliographically approved
Jacobson, S., Dahlqvist, P., Johansson, M., Svensson, J., Billing, O., Sund, M. & Franklin, O. (2021). Hyperglycemia as a risk factor in pancreatic cancer: A nested case-control study using prediagnostic blood glucose levels. Pancreatology (Print), 21(6), 1112-1118
Open this publication in new window or tab >>Hyperglycemia as a risk factor in pancreatic cancer: A nested case-control study using prediagnostic blood glucose levels
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2021 (English)In: Pancreatology (Print), ISSN 1424-3903, E-ISSN 1424-3911, Vol. 21, no 6, p. 1112-1118Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To determine the risk association between fasting glucose levels and pancreatic cancer using systematically collected prediagnostic blood glucose samples.

METHODS: Prospective nested case-control study of participants from the Northern Sweden Health and Disease Study, including 182 cases that developed pancreatic cancer and four matched controls per case. Blood glucose levels collected up to 24 years before pancreatic cancer diagnosis were analyzed. The association between fasting glucose levels and pancreatic cancer risk was determined using unconditional and conditional logistic regression models. The association between fasting glucose and the time to pancreatic cancer diagnosis, tumor stage and survival was determined using likelihood-ratio test, t-test and log rank test.

RESULTS: The unadjusted risk of developing pancreatic cancer increased with increasing fasting glucose levels (OR 1.30, 95% CI 1.05-1.60, P = .015). Impaired fasting glucose (≥6.1 mmol/L) was associated with an adjusted risk of 1.77 for developing pancreatic cancer (95% CI 1.05-2.99, P = .032). In subgroup analysis, fasting glucose levels were associated with an increased risk in never-smokers (OR 4.02, 95% CI 1.26-12.77, P = .018) and non-diabetics (OR 3.08, 95% CI 1.08-8.79, P = .035) (non-significant for interaction). The ratio between fasting glucose and BMI was higher among future pancreatic cancer patients and an increased ratio was associated with elevated risk of pancreatic cancer (OR 1.66, 95% CI 1.04-2.66, P = .034). Fasting glucose levels were not associated with TNM stage at diagnosis or survival.

CONCLUSIONS: High fasting glucose is associated with an increased risk of being diagnosed with pancreatic cancer.

Place, publisher, year, edition, pages
Elsevier, 2021
Keywords
Early detection, Fasting glucose, Pancreatic ductal adenocarcinoma, Risk analysis
National Category
Surgery
Identifiers
urn:nbn:se:umu:diva-184041 (URN)10.1016/j.pan.2021.05.008 (DOI)000727779500013 ()34049822 (PubMedID)2-s2.0-85106561109 (Scopus ID)
Funder
Swedish Cancer Society, 19027Swedish Cancer Society, 2016-643Swedish Research Council, 2016-02990Swedish Research Council, 2019-01690
Available from: 2021-06-08 Created: 2021-06-08 Last updated: 2023-09-26Bibliographically approved
Franklin, O., Öman, M. & Wanders, A. (2020). A Case of Pancreatic Ductal Adenocarcinoma Arising From Atypical Flat Lesions [Letter to the editor]. Pancreas, 49(7), E60-E61
Open this publication in new window or tab >>A Case of Pancreatic Ductal Adenocarcinoma Arising From Atypical Flat Lesions
2020 (English)In: Pancreas, ISSN 0885-3177, E-ISSN 1536-4828, Vol. 49, no 7, p. E60-E61Article in journal, Letter (Refereed) Published
Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2020
National Category
Gastroenterology and Hepatology
Identifiers
urn:nbn:se:umu:diva-174019 (URN)10.1097/MPA.0000000000001591 (DOI)000553345100001 ()32658071 (PubMedID)2-s2.0-85088241785 (Scopus ID)
Available from: 2020-08-18 Created: 2020-08-18 Last updated: 2023-03-23Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-3777-6887

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