[Clinicopathologic features and lipid profile characteristics of early-onset pancreatic cancer]

Objective: To explore the clinicopathologic features of early-onset pancreatic cancer (EOPC) and its correlation with dyslipidemia and prognostic analysis. Methods: This is a retrospective cohort study. Clinical and pathological data of 455 patients with pancreatic cancer who underwent radical surgery from January 2013 to September 2020 in the Department of Pancreatic Surgery, Qilu Hospital, Shandong University were retrospectively collected. According to the onset age≤50 years, the patients were divided into EOPC group(67 cases) and later-onset pancreatic cancer (LOPC) group(388 cases). There were 48 males and 19 females in the EOPC group, aged (44.4±5.7) years(range: 28.0 to 50.0 years); and 230 males and 158 females in the LOPC group, aged (63.0±7.2)years (range: 51.0 to 86.0 years). EOPC was divided into two groups according to the blood lipid status: dyslipidemia (50 cases) and normal (17 cases). General information, blood lipid data, clinicopathological parameters and follow-up information were collected. χ² test, Mann-Whitney U test and Logistic regression analysis were used to evaluate the difference or correlation between groups, and Cox regression analysis and Kaplan-Meier survival curve were used to analyze the impact of EOPC and dyslipidemia on the prognosis. Propensity score matching was used to match two groups of patients in a 1∶1 ratio using nearest neighbor matching, with a caliper set at 0.05. Results: Compared with LOPC group, EOPC group with a higher proportion of patients with body mass index ≥24 kg/m² (55.8%(24/43) vs. 38.7%(113/292),χ²=4.542,P=0.033), dyslipidemia(74.6%(50/67) vs. 57.7%(224/388), χ²=6.808,P=0.009), pancreatic head cancer (73.1% (49/67) vs. 60.0%(231/385), χ²=4.176,P=0.041) and a lower proportion of patients with type 2 diabetes (9.0%(6/67) vs. 24.2%(94/388), χ²=7.771,P=0.005) and hypertension (9.0%(6/67) vs. 33.0%(128/388), χ²=15.885,P<0.01). Compared the proportion of dyslipidemia in the two groups,there was a higher proportion of high density lipoprotein cholesterol(HDL-C) abnormality in the EOPC group (65.7%(44/67) vs. 42.8%(166/388),χ²=12.044,P<0.01), whereas there was no significant difference in other lipid indices. Kaplan-Meier survival curve analysis of dyslipidemia did not have a significant effect on the prognosis of EOPC patients (P=0.430). The results of further Logistic regression analysis showed that gender(OR=6.445 (95% CI: 1.692 to 24.548), P=0.006) and tumor location (OR=5.352 (95% CI: 1.374 to 20.846), P=0.016) were independent related factors with serum lipid level in patients with EOPC. Conclusions: Compared with LOPC, EOPC is more likely to be combined with obesity and HDL-C abnormalities, and the proportion of pancreatic head cancer is also higher, but there is no significant difference in prognosis between the two groups. In the EOPC patients, serum lipid level is associated with gender and tumor site, but has no effect on survival.