Risk factors for gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs): a three-centric case–control study
Purpose Risk factors for sporadic GEP-NENs are still not well defined. To identify the main clinical risk factors represents the aim of this study performed by three Italian referral centers for NENs. Methods We performed a retrospective case–control study including 148 consecutive sporadic GEP-NENs...
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Published in | Journal of endocrinological investigation Vol. 45; no. 4; pp. 849 - 857 |
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Main Authors | , , , , , , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Cham
Springer International Publishing
01.04.2022
Springer Nature B.V |
Subjects | |
Online Access | Get full text |
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Summary: | Purpose
Risk factors for sporadic GEP-NENs are still not well defined. To identify the main clinical risk factors represents the aim of this study performed by three Italian referral centers for NENs.
Methods
We performed a retrospective case–control study including 148 consecutive sporadic GEP-NENs and 210 age- and sex-matched controls. We collected data on clinical features, cancer family history and other potential risk factors.
Results
Mean age was 58.3 ± 15.8 years; 50% males, primary site was pancreas (50.7%), followed by ileum (22.3%). The 62.8% and 29.1% of cases were G1 and G2, respectively; the 40% had locally advanced or metastatic disease at diagnosis. Independent risk factors for GEP-NENs were: family history of non-neuroendocrine GEP cancer (OR 2.16, 95% CI 1.31–3.55,
p
= 0.003), type 2 diabetes mellitus (T2DM) (OR 2.5, 95% CI 1.39–4.51,
p
= 0.002) and obesity (OR 1.88, 95% CI 1.18–2.99,
p
= 0.007). In the T2DM subjects, metformin use was a protective factor (OR 0.28, 95% CI 0.08–0.93,
p
= 0.049). T2DM was also associated with a more advanced (OR 2.39, 95% CI 1.05–5.46,
p
= 0.035) and progressive disease (OR 2.47, 95% CI 1.08–5.34,
p
= 0.03). Stratifying cases by primary site, independent risk factors for pancreatic NENs were T2DM (OR 2.57, 95% CI 1.28–5.15,
p
= 0.008) and obesity (OR 1.98, 95% CI 1.11–3.52,
p
= 0.020), while for intestinal NENs family history of non-neuroendocrine GEP cancer (OR 2.46, 95% CI 1.38–4.38,
p
= 0.003) and obesity (OR 1.90, 95% CI 1.08–3.33,
p
= 0.026).
Conclusion
This study reinforces a role for family history of non-neuroendocrine GEP cancer, T2DM and obesity as independent risk factors for GEP-NENs and suggests a role of metformin as a protective factor in T2DM subjects. If confirmed, these findings could have a significant impact on prevention strategies for GEP-NENs. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 1720-8386 0391-4097 1720-8386 |
DOI: | 10.1007/s40618-021-01715-0 |