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Survival Outcome and Prognostic Factors for Pancreatic Acinar Cell Carcinoma: Retrospective Analysis from the German Cancer Registry Group

胰腺腺泡細(xì)胞癌的生存結(jié)果和預(yù)后因素：德國癌癥登記組的回顧性分析

Less than 1% of all pancreatic malignancies are acinar cell carcinomas. Based on data from the German Cancer Registry Group, we performed a comparative analysis of characteristics and prognostic factors of pancreatic acinar cell carcinoma and the most common type of pancreatic cancer—pancreatic ductal adenocarcinoma. Compared to pancreatic ductal adenocarcinoma, patients with pancreatic acinar cell carcinoma were younger at the time of diagnosis and the percentage of males was higher. The prognosis of patients with pancreatic acinar carcinoma was better than that of patients with pancreatic ductal adenocarcinoma. Surgical resection was the strongest positive prognostic factor for pancreatic acinar cell carcinoma. The study shows that pancreatic acinar cell carcinoma has features distinct from pancreatic ductal adenocarcinoma. Radical resection should be advocated, whenever feasible.

不到 1% 的胰腺惡性腫瘤是腺泡細(xì)胞癌。基于德國癌癥登記組的數(shù)據(jù)，我們對胰腺腺泡細(xì)胞癌和最常見的胰腺癌類型——胰腺導(dǎo)管腺癌的特征和預(yù)后因素進(jìn)行了比較分析。與胰腺導(dǎo)管腺癌相比，胰腺腺泡細(xì)胞癌患者在診斷時更年輕，男性比例更高。胰腺腺泡癌患者的預(yù)后優(yōu)于胰腺導(dǎo)管腺癌患者。手術(shù)切除是胰腺腺泡細(xì)胞癌最強(qiáng)的陽性預(yù)后因素。研究表明，胰腺腺泡細(xì)胞癌具有不同于胰腺導(dǎo)管腺癌的特征。

細(xì)胞搖瓶

Background: Pancreatic acinar cell carcinoma (PACC) is a distinct type of pancreatic cancer with low prevalence. We aimed to analyze prognostic factors and survival outcome for PACC in comparison to pancreatic ductal adenocarcinoma (PDAC), based on data from the German Cancer Registry Group. Methods: Patients with PACC and PDAC were extracted from pooled data of the German clinical cancer registries (years 2000 to 2019). The distribution of demographic parameters, tumor stage and therapy modes were compared between PACC and PDAC. The Kaplan–Meier method and Cox regression analysis were used to delineate prognostic factors for PACC. Propensity score matching was used to compare survival between PACC and PDAC. Results: There were 233 (0.44%) patients with PACC out of 52,518 patients with pancreatic malignancy. Compared to PDAC, patients with PACC were younger (median age 66 versus 70, respectively, p < 0.001) and the percentage of males was higher (66.1% versus 53.3%, respectively, p < 0.001). More patients were resected with PACC than with PDAC (56.2% versus 38.9%, respectively, p < 0.001). The estimated overall median survival in PACC was 22 months (95% confidence interval 15 to 27), compared to 12 months (95% confidence interval 10 to 13) in the matched PDAC cohort (p < 0.001). Surgical resection was the strongest positive prognostic factor for PACC after adjusting for sex, age, and distant metastases (hazard ratio 0.34, 95% confidence interval 0.22 to 0.51, p < 0.001). There was no survival benefit for adjuvant therapy in PACC. Conclusions: PACC has overall better prognosis than PDAC. Surgical resection is the best therapeutic strategy for PACC and should be advocated even in advanced tumor stages.

細(xì)胞培養(yǎng)瓶

胰腺腺泡細(xì)胞癌 (PACC) 是一種獨特類型的胰腺癌，發(fā)病率較低。我們旨在根據(jù)德國癌癥登記組的數(shù)據(jù)分析 PACC 與胰腺導(dǎo)管腺癌 (PDAC) 的預(yù)后因素和生存結(jié)果。方法：從德國臨床癌癥登記處（2000 年至 2019 年）的匯總數(shù)據(jù)中提取 PACC 和 PDAC 患者。比較 PACC 和 PDAC 的人口統(tǒng)計學(xué)參數(shù)分布、腫瘤分期和治療模式。Kaplan-Meier 方法和 Cox 回歸分析用于描述 PACC 的預(yù)后因素。傾向評分匹配用于比較 PACC 和 PDAC 之間的生存率。結(jié)果：在 52,518 名胰腺惡性腫瘤患者中，有 233 名 (0.44%) 患者患有 PACC。與 PDAC 相比，p < 0.001）并且男性比例更高（分別為 66.1% 和 53.3%，p < 0.001）。與 PDAC 相比，使用 PACC 切除的患者更多（分別為 56.2% 和 38.9%，p < 0.001）。PACC 中估計的總中位生存期為 22 個月（95% 置信區(qū)間 15 至 27），而匹配的 PDAC 隊列為 12 個月（95% 置信區(qū)間 10 至 13）（p < 0.001）。在調(diào)整性別、年齡和遠(yuǎn)處轉(zhuǎn)移后，手術(shù)切除是 PACC 最強(qiáng)的陽性預(yù)后因素（風(fēng)險比 0.34，95% 置信區(qū)間 0.22 至 0.51，p< 0.001)。PACC 的輔助治療沒有生存獲益。結(jié)論：PACC的總體預(yù)后優(yōu)于PDAC。手術(shù)切除是 PACC 的最佳治療策略，即使在晚期腫瘤階段也應(yīng)提倡。

細(xì)胞工廠

It is important to bear in mind that PACC has features distinct from PDAC. Radical surgical resection should be advocated, including resection of metastases, whenever feasible. Though the role of systemic therapy is not well defined, it should be considered at least for patients with advanced disease.

重要的是要記住 PACC 具有與 PDAC 不同的特征。在可行的情況下，應(yīng)提倡根治性手術(shù)切除，包括切除轉(zhuǎn)移灶。盡管全身治療的作用尚不明確，但至少應(yīng)考慮對晚期疾病患者進(jìn)行治療。

關(guān)鍵詞： 胰腺腺泡細(xì)胞癌,胰腺癌,德國癌癥登記組,pancreatic acinar cell carcinoma,pancreatic cancer,German Cancer Registry Group

來源：MDPI https://www.mdpi.com/2072-6694/13/23/6121/htm