Clinical characteristics and risk factors of liver metastasis from pancreatic cancer

doi:10.3877/cma.j.issn.2095-3232.2026.01.012

Abstract

Abstract:

Objective

To investigate clinical characteristics and risk factors of liver metastasis from pancreatic cancer, aiming to provide scientific evidence for prevention, screening and treatment of this population.

Methods

Clinical data of 593 patients with pancreatic cancer admitted to Peking Union Medical College Hospital from January 2013 to December 2023 were retrospectively analyzed. Among them, 275 patients were male and 318 female, aged from 25 to 85 years, with a median age of 62 years. All patients were divided into the liver metastasis group (n=157) and control group (n=436). Clinical characteristics of liver metastasis from pancreatic cancer were summarized. The influencing factors of liver metastasis from pancreatic cancer were assessed by multivariate Logistic regression analysis. Multiple covariates consisting of gender, age, smoking, drinking, diabetes mellitus, surgery, metabolism-associated fatty liver disease (MAFLD), WBC, neutrophils, lymphocytes, ALT, AST, TB, DB, GGT, ALP, Scr, ALB, CA19-9 and CEA were included.

Results

The incidence of liver metastasis from pancreatic cancer was 26.5%(157/593). The proportion of patients with liver metastasis from pancreatic cancer who smoked and were complicated with MAFLD was increased significantly, while the proportion of patients undergoing surgery was relatively low (χ²= 5.18,108.04,40.50; all P<0.05). ALT, ALT/AST, GGT, ALP and CA19-9 levels were significantly increased, and blood urea nitrogen level was significantly decreased (Z=2.97, 3.21, 3.48, 2.35, 3.43, 2.78; all P<0.05). Multivariate Logistic analysis showed that smoking (OR=1.703, 95%CI: 1.046-2.771) and MAFLD (OR=9.153, 95%CI: 5.732-14.617) were the independent risk factors for liver metastasis in patients with pancreatic cancer (both P<0.05). Surgery is an important protective factor for pancreatic cancer patients with liver metastasis (OR=0.260, 95%CI: 0.166-0.407, P<0.05).

Conclusions

The incidence of liver metastasis from pancreatic cancer is relatively high. MAFLD and smoking are the independent risk factors, whereas surgery is a protective factor for for liver metastasis from pancreatic cancer. Surgical resection is recommended for patients with resectable pancreatic cancer. Smoking cessation should be included in the whole management of pancreatic cancer patients. Extensive attention should be diverted to the screening of pancreatic cancer patients with high-risk MAFLD. Health education on MAFLD and smoking risk knowledge should be strengthened.

Key words: Pancreatic cancer, Liver metastasis, Risk factors, Preventive measures, Metabolic associated fatty liver disease

Hui Song, Liang Zhu, Qian Yu. Clinical characteristics and risk factors of liver metastasis from pancreatic cancer[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2026, 15(01): 73-78.

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References 31

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指标	肝转移组	对照组	统计值	P值
性别(例, 男/女)	80/77	195/241	χ²=1.80	0.179
年龄[岁, M(Q₁, Q₃)]	62(55, 68)	63(56, 68)	Z=-0.48	0.631
WBC[×10⁹/L, M(Q₁, Q₃)]	6.0 (5.1, 7.2)	5.8 (4.9, 7.1)	Z=1.43	0.153
中性粒细胞[×10⁹/L, M(Q₁, Q₃)]	4.0(3.1, 4.9)	3.7(2.9, 4.6)	Z=1.77	0.076
淋巴细胞[×10⁹/L, M(Q₁, Q₃)]	1.5(1.1, 1.9)	1.5(1.1, 1.9)	Z=0.80	0.421
血尿酸[μmol/L, M(Q₁, Q₃)]	267 (211, 319)	266 (217, 325)	Z=0.79	0.429
血尿素氮[g/L, M(Q₁, Q₃)]	4.4 (3.6, 5.2)	4.7 (3.9, 5.7)	Z=-2.78	0.005
Scr[μmol/L, M(Q₁, Q₃)]	62(52, 72)	62(54, 73)	Z=-0.86	0.389
ALB[g/L, M(Q₁, Q₃)]	43(41, 45)	43(40, 45)	Z=0.63	0.531
ALT[U/L, M(Q₁, Q₃)]	30(18, 243)	22(14, 140)	Z=2.97	0.003
AST[U/L, M(Q₁, Q₃)]	25(18, 144)	23(18, 81)	Z=1.65	0.099
ALT/AST[M(Q₁, Q₃)]	1.2(0.8, 1.6)	1.0(0.7, 1.3)	Z=3.21	0.001
TB[μmol/L, M(Q₁, Q₃)]	16.8(10.8, 113.6)	14.8(10.2, 68.0)	Z=1.72	0.086
DB[μmol/L, M(Q₁, Q₃)]	5.2(3.6, 84.6)	5.0(3.3, 50.6)	Z=1.66	0.097
GGT[U/L, M(Q₁, Q₃)]	68(25, 627)	32(18, 319)	Z=3.48	<0.001
LDH[IU/L, M(Q₁, Q₃)]	188(163, 248)	186(162, 215)	Z=1.87	0.062
ALP[IU/L, M(Q₁, Q₃)]	113(81, 296)	94(714, 291)	Z=2.35	0.019
CA19-9[kU/L, M(Q₁, Q₃)]	309(89, 745)	142(49, 439)	Z=3.43	<0.001
CEA[mg/L, M(Q₁, Q₃)]	3.5(2.3, 5.9)	3.2 (2.0, 5.0)	Z=1.90	0.057
糖尿病(例)	40	116	χ²=0.08	0.783
吸烟(例)	46	89	χ²=5.18	0.023
手术(例)	69	315	χ²=40.50	<0.001
MAFLD(例)	89	63	χ²=108.04	<0.001

指标	肝转移组	对照组	统计值	P值
性别(例, 男/女)	80/77	195/241	χ²=1.80	0.179
年龄[岁, M(Q₁, Q₃)]	62(55, 68)	63(56, 68)	Z=-0.48	0.631
WBC[×10⁹/L, M(Q₁, Q₃)]	6.0 (5.1, 7.2)	5.8 (4.9, 7.1)	Z=1.43	0.153
中性粒细胞[×10⁹/L, M(Q₁, Q₃)]	4.0(3.1, 4.9)	3.7(2.9, 4.6)	Z=1.77	0.076
淋巴细胞[×10⁹/L, M(Q₁, Q₃)]	1.5(1.1, 1.9)	1.5(1.1, 1.9)	Z=0.80	0.421
血尿酸[μmol/L, M(Q₁, Q₃)]	267 (211, 319)	266 (217, 325)	Z=0.79	0.429
血尿素氮[g/L, M(Q₁, Q₃)]	4.4 (3.6, 5.2)	4.7 (3.9, 5.7)	Z=-2.78	0.005
Scr[μmol/L, M(Q₁, Q₃)]	62(52, 72)	62(54, 73)	Z=-0.86	0.389
ALB[g/L, M(Q₁, Q₃)]	43(41, 45)	43(40, 45)	Z=0.63	0.531
ALT[U/L, M(Q₁, Q₃)]	30(18, 243)	22(14, 140)	Z=2.97	0.003
AST[U/L, M(Q₁, Q₃)]	25(18, 144)	23(18, 81)	Z=1.65	0.099
ALT/AST[M(Q₁, Q₃)]	1.2(0.8, 1.6)	1.0(0.7, 1.3)	Z=3.21	0.001
TB[μmol/L, M(Q₁, Q₃)]	16.8(10.8, 113.6)	14.8(10.2, 68.0)	Z=1.72	0.086
DB[μmol/L, M(Q₁, Q₃)]	5.2(3.6, 84.6)	5.0(3.3, 50.6)	Z=1.66	0.097
GGT[U/L, M(Q₁, Q₃)]	68(25, 627)	32(18, 319)	Z=3.48	<0.001
LDH[IU/L, M(Q₁, Q₃)]	188(163, 248)	186(162, 215)	Z=1.87	0.062
ALP[IU/L, M(Q₁, Q₃)]	113(81, 296)	94(714, 291)	Z=2.35	0.019
CA19-9[kU/L, M(Q₁, Q₃)]	309(89, 745)	142(49, 439)	Z=3.43	<0.001
CEA[mg/L, M(Q₁, Q₃)]	3.5(2.3, 5.9)	3.2 (2.0, 5.0)	Z=1.90	0.057
糖尿病(例)	40	116	χ²=0.08	0.783
吸烟(例)	46	89	χ²=5.18	0.023
手术(例)	69	315	χ²=40.50	<0.001
MAFLD(例)	89	63	χ²=108.04	<0.001

因素	b	SE(b)	Wald χ²	OR	95% CI	P值
吸烟	0.532	0.249	4.584	1.703	1.046~2.771	0.032
手术	-1.348	0.229	34.598	0.260	0.166~0.407	<0.001
MAFLD	2.214	0.239	85.951	9.153	5.732~14.617	<0.001
ALT	0.001	0.001	2.108	1.001	1.000~1.003	0.146
TB	-0.002	0.001	2.304	0.998	0.995~1.001	0.129
LDH	-0.000	0.002	0.001	1.000	0.996~1.004	0.978
血尿素氮	-0.108	0.078	1.938	0.897	0.770~1.045	0.164
CA19-9	0.000	0.000	1.809	1.000	1.000~1.000	0.179
CEA	0.014	0.007	3.748	1.014	1.000~1.029	0.053

因素	b	SE(b)	Wald χ²	OR	95% CI	P值
吸烟	0.532	0.249	4.584	1.703	1.046~2.771	0.032
手术	-1.348	0.229	34.598	0.260	0.166~0.407	<0.001
MAFLD	2.214	0.239	85.951	9.153	5.732~14.617	<0.001
ALT	0.001	0.001	2.108	1.001	1.000~1.003	0.146
TB	-0.002	0.001	2.304	0.998	0.995~1.001	0.129
LDH	-0.000	0.002	0.001	1.000	0.996~1.004	0.978
血尿素氮	-0.108	0.078	1.938	0.897	0.770~1.045	0.164
CA19-9	0.000	0.000	1.809	1.000	1.000~1.000	0.179
CEA	0.014	0.007	3.748	1.014	1.000~1.029	0.053

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