Pancreatic ductal adenocarcinoma (PDAC) is usually diagnosed late, leading to a high mortality rate. Early detection facilitates better treatment options. The aim of this UK-based case–control study was to determine whether two validated tests for pancreatic exocrine insufficiency (PEI), namely, the13C-mixed triglyceride breath test (13C-MTGBT) and a faecal elastase (FE-1) test, can discriminate between patients with resectable PDAC versus healthy volunteers (HVs) along with a comparison group with chronic pancreatitis (CP). Discrimination between disease states and HVs was tested with receiver operator characteristic (ROC) curves. In total, 59 participants (23 PDAC (16 men), 24 HVs (13 men) and 12 CP (10 men)) were recruited, with a similar age in each population, and a combined median (IQR) age of 66 (57–71). The areas under the ROC curve for discriminating between PDAC and HVs were 0.83 (95% CI: 0.70–0.96) for the13C-MTGBT, and 0.85 (95% CI: 0.75–0.95) for the FE-1 test. These were similar to CP vs. HV. In conclusion, PEI occurs in resectable PDAC to a similar extent as in CP; further large-scale, prospective studies using these tests in the primary care setting on high-risk groups are warranted.
胰腺导管腺癌（PDAC）通常诊断较晚，导致死亡率较高。早期检测有助于提供更好的治疗选择。这项基于英国的病例对照研究旨在确定两种经过验证的胰腺外分泌功能不全（PEI）检测方法——即13C-混合甘油三酯呼气试验（13C-MTGBT）和粪便弹性蛋白酶-1（FE-1）检测——能否区分可切除PDAC患者与健康志愿者（HVs），并与慢性胰腺炎（CP）组进行比较。通过受试者工作特征（ROC）曲线检验疾病状态与健康志愿者之间的区分能力。研究共招募59名参与者（23例PDAC患者（16名男性）、24名健康志愿者（13名男性）和12例慢性胰腺炎患者（10名男性）），各组年龄分布相似，总体中位年龄（四分位距）为66岁（57-71岁）。区分PDAC与健康志愿者的ROC曲线下面积分别为：13C-MTGBT检测0.83（95% CI: 0.70–0.96），FE-1检测0.85（95% CI: 0.75–0.95），其区分效能与慢性胰腺炎组对比健康志愿者组的结果相似。结论表明，可切除PDAC患者的胰腺外分泌功能不全程度与慢性胰腺炎患者相当；有必要在初级保健机构中对高危人群使用这些检测方法开展进一步的大规模前瞻性研究。
肿瘤(癌症)患者之家