A Potential Screening Strategy of Pancreatic Cancer in New Onset Diabetes Patients Using Serum CA19-9 in Combination With Age and BMI: 7

Introduction: Type 2 diabetes mellitus is widely considered to be associated with pancreatic cancer. New-onset diabetic mellitus (NODM) is recently recognized as the early symptom of pancreatic cancer (PC). We aimed to establish screening strategy based on NODM for PC using serum CA19-9 and clinic characteristics. Methods: Preoperative serum levels of CA19-9 and clinicopathological characteristics were retrospectively analyzed in consecutive 30 with or 30 without pancreatic ductal adenocarcinoma (PDA) in newonset diabetes (less than 24 months) patients. Results: Patients studied are described in more detail in Table 1. The gender distribution and Fasting Blood Glucose (FBG) was similar in both groups. The average age of the 2 groups was significantly different (P= 0.01) with the NODM group being younger than the PC with NODM group, the average age (SD) are 62.85(9.86) year and 76(9.94) respectively. The BMI of malignant group was lower than NODM group (they are 21.63±3.03 Kg/Mˆ2 and 24.77±3.80 Kg/Mˆ2 respectively), and the duration of DM was also shorter in PC group. The ROC curve based on CA19-9 resulted in an AUC of 0.975 (95% CI, 0.943-1.0), at the cut-off value of 35u/l, the sensitivity and specificity were 82.8% and 100% respectively. Furthermore, in subgroup of patients BMI>22, 11 NODM with PC and 21 NODM were included, AUC of serum CA19-9 was 1, at the cut-off value of 35u/l, the sensitivity and specificity were both 100% and 100% respectively.Table: Table. Characteristics of the study subjectsConclusion: The NODM patients with old age and low BMI are more likely to be PC. Screening for pancreatic cancer (PC) based on NO-DM using serum CA19-9 have low sensitivity but high specificity, but in BMI>22 patients, the diagnostic accuracy of serum ca19-9 is more high. However, our hypothesis needed more data to support.