Study On The Relationship Between Drug Allergy And Occurrence And Lymph Node Metastasis Of Pancreatic Cancer

Background and Objective: Pancreatic cancer is a highly malignant tumor originating from pancreatic ductal epithelium and acinar cells.Early diagnosis is difficult and the prognosis is poor.In recent years,its morbidity have increased significantly.Lymph node metastasis or not is an important index to evaluate the prognosis of patients.Drug allergy is an allergic reaction to a drug,usually in people with an allergic constitution,now more and more studies have shown that allergic constitution has a reverse correlation with pancreatic cancer,but there is no association between allergy and lymph node metastasis in pancreatic cancer.In this study,we will verify the reverse correlation between drug allergy and pancreatic cancer,and further to explore the relationship of drug allergy and lymph node metastasis of pancreatic cancer.The aim of this study is to suggest the independent risk factor,immunological treatment and prognosis of pancreatic cancer.Methods: a total of 400 patients with pancreatic cancer admitted to the affiliated hospital of Qingdao university from January 2013 to December 2019 were selected,all of whom were pathologically diagnosed as ductal adenocarcinoma.The following situations should be excluded: The pathological type was not ductal adenocarcinoma or contained two or more pathological types;No complete pathological data were available;Survival less than three months after surgery;Presence of other malignancies,including lymphoma and leukemia;Received immunosuppressive agents and cytotoxic drugs within the past six months;Serious diseases of other vital organs or systems and rheumatic diseases exist.In the control group,400 patients with gender and age matched with the case group who underwent physical examination in the affiliated hospital of Qingdao university at the same time were selected.Meanwhile,those with malignant tumors,rheumatic diseases and other serious diseases of vital organs or systems were also excluded.General data including age,sex,BMI,drug allergy history,smoking and drinking history were collected,and the test results of white blood cell count(WBC),platelet count(PLT),hemoglobin(HB),alanine aminotransferase(ALT),total bilirubin(TBIL),albumin(ALB),creatinine(Crea),serum sodium(Na),serum potassium(K),carcinoembryonic antigen(CEA)and carbohydrate antigen ca19-9 were analyzed after admission,as well as the pathological examination results within 15 days.Statistical software SPSS22.0 was used for statistical analysis of the data.The enumeration data were expressed as positive cases and percentage(%).The measurement data were expressed as mean ± standard deviation(x±s).Logistic regression analysis was used for multivariate analysis.Taking a =0.05 as the test level,P < 0.05 indicates that the difference is statistically significant.Results:1.After matching,there was no significant gender difference between the pancreatic cancer group and the healthy control group(P < 0.05);The mean age of pancreatic cancer group was 63.2±9.3 years,and that of control group was 62.8±9.8years.(P < 0.05).2.The drug allergy rate in the pancreatic cancer group was significantly different from that in the healthy control group(P=0.04).The drug allergy rate in the healthy control group was 14.5%,higher than that in the pancreatic cancer group(9.8%).3.Univariate analysis showed that in patients with pancreatic cancer,the drug allergy rate in the lymph node metastasis group was lower(8.2% vs.10.3%,P = 0.031),and the total bilirubin level was higher(median/tetrad spacing was 60.6(218.6)vs.21.6(140.5),P = 0.031).4.Logistic regression analysis found that patients with a history of drug allergy(OR =0.376;95%CI,0.143-0.993;P=0.048)and low total bilirubin(OR =1.002;95%CI,1.000-1.003;P= 0.029)had a reduced risk of lymph node metastasis from pancreatic cancer.5.Among the 39 patients allergic to drugs,34 patients had allergic reactions to only one drug,and 5 patients had allergic reactions to two or three drugs.19 patients were allergic to penicillin or cephalosporin,and 9 patients were allergic to sulfonamides.The type of allergy drug was not associated with lymph node metastasis in pancreatic cancer.Conclusion: 1 There is inverse correlation between drug allergy and pancreatic cancer.2 Absence of drug allergy is an independent risk factor for lymph node metastasis in pancreatic cancer patients,and high bilirubin level is associated with lymph node metastasis in pancreatic cancer.3 The type of allergy drug is not associated with lymph node metastasis in pancreatic cancer.