RESUMO
BACKGROUND: The purpose of this study was to find the factors that may be helpful for differentiating pancreatic cancer-associated diabetes mellitus (PC + DM) from common type 2 diabetes for the early diagnosis of pancreatic cancer. METHODS: From January 2008 to August 2013, 171 patients with pancreatic cancer and new-onset diabetes were recruited for the study; 242 age- and gender-matched patients with common type 2 diabetes were also identified as control during the same period. The patient's characteristics and laboratory parameters were compared between the 2 groups. RESULTS: By multivariate logistic regression analysis, we found that body mass index (BMI), the age of onset of diabetes, hepatitis B virus (HBV) infection, total bilirubin (TBIL), alanine aminotransferase (ALT), creatinine (Cr), apolipoprotein-A1 (APO-A1), and white blood cell (WBC) were independent predictive factors for differentiating PC + DM from common type 2 diabetes; the areas under receiver operating characteristic curves were up to 0.815 for the combination of these 8 markers. CONCLUSIONS: These results suggest that BMI, the age of onset of diabetes, HBV infection, TBIL, ALT, Cr, APO-A1, and WBC are factors that could differentiate PC + DM from common type 2 -diabetes and may be used for early diagnosis of pancreatic cancer.
Assuntos
Diabetes Mellitus Tipo 2/diagnóstico , Detecção Precoce de Câncer , Neoplasias Pancreáticas/diagnóstico , Adulto , Idade de Início , Idoso , Idoso de 80 Anos ou mais , Alanina Transaminase/sangue , Apolipoproteína A-I/sangue , Bilirrubina/sangue , Biomarcadores/análise , Índice de Massa Corporal , Estudos de Casos e Controles , Creatinina/sangue , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/etiologia , Diagnóstico Diferencial , Feminino , Hepatite B/sangue , Hepatite B/diagnóstico , Hepatite B/virologia , Vírus da Hepatite B/isolamento & purificação , Humanos , Contagem de Leucócitos , Masculino , Pessoa de Meia-Idade , Neoplasias Pancreáticas/sangue , Neoplasias Pancreáticas/complicações , Estudos RetrospectivosRESUMO
Acute cholecystitis is not a common complication of gastrectomy. Its clinical presentations and management strategies in old patients have not been well described in available literature. This report describes the clinical features, management strategies, and treatment outcome of acute cholecystitis immediately after gastrectomy. Acute cholecystitis immediately after gastrectomy in old patients has different clinical presentations, such as fever and high plasma C-reaction protein level. Abdominal computed tomography (CT) scan and ultrasonography showed acute cholecystitis in our cases, which was treated with antibiotics and ultrasound-guided percutaneous transhepatic gallbladder drainage (PTGD). The results indicate that abdominal CT scan and ultrasonography can effectively diagnose acute cholecystitis after gastrectomy, which can be effectively treated with antibiotics and PTGD.