http://www.revistadechimie.ro REV.CHIM.(Bucharest)♦69♦No. 12♦2018 3500 * email:zabara_mihai@yahoo.com; bogdanmciuntu@yahoo.com The Influence of Diabetes Mellitus in Development and Prognostic of Pancreatic Neoplasia ANA MARIA TROFIN 1 , MIHAI ZABARA 1 *, RAMONA CADAR 2 , MADALINA PALAGHIA 1 , DELIA RUSU-ANDRIESI 1 , BOGDAN MIHNEA CIUNTU 1 *, IRENE ALEXANDRA SPIRIDON 3 , CRISTIAN LUPASCU 1 1 Grigore T. Popa University of Medicine and Pharmacy, Faculty of General Medicine, Surgery Discipline, 16 Universitatii Str., 700115 Iasi, Rom ania 2 Saint Spiridon Hospital Iasi, II nd Surgical Department, 1 Independentei Blvd., 700111 Iasi, Romania 3 Grigore T. Popa University of Medicine and Pharmacy, Faculty of General Medicine, Morphopatology Department, 16 Universitatii Str., 700115 Iasi, Romania Pancreatic cancer is one of the most aggressive malignant diseases due high rate of recurrence and the lack effective medical therapy. Surgery remains the only option for curable treatment but unfortunately, less than 20% of patients are eligibles at the time of diagnosis therefore identifying the risk factors represent a big step for cancer research. Pancreatic cancer is frequently associated with diabetes or glucose intolerance. There are two hypotheses at the base of this observation: either the diabetes cause pancreatic cancer or is a concequences of the cancer. In these theses we studied the patients diagnosticated with pancreatic cancer and with diabetes mellitus type 2. A total of 256 pancreatic cancer cases were identified and 71 patients had diabetes mellitus and 21 patients had glucose intolerance. Mean age 62.2 years, 81% cases were male and in 71% cancer originated form the pancreatic head. In 51.4% cases the diagnosis was in stage IV of the disease. Patients with pancreatic cancer and diabetes mellitus had reduced survival compared with those without diabetes but the difference was not statistically significant. Diabetes mellitus is associated with a decreased survival among patients with pancreatic cancer and reveal a link between chronic glucose intolerance and pancreatic cancer survival. The complex relationship between pancreatic cancer and diabetes requires more clinical research in order to developed new therapeutical posibilities. Keywords: pancreatic cancer, diabetes mielitus, survival, glucose intolerance . Pancreatic cancer is currently one of the most fatal malignant diseases due to the late diagnosis, high rate of recurrence and the lack effective medical therapy [1]. In this moment, surgery remains the only curable treatment option. Unfortunately, less than 20% of patients are eligibles for surgery at the time of diagnosis and even in this situation the median postoperative survival is under 20 months with a 5-year survival of approximately 20% [2]. Pancreatico- duodenectomy (PD) is the most common procedure performed for pancreatic cancer and is a challenging procedure operformed for tumors of pancreatic head associated with a perioperative morbidity of 30% Today, pancreaticoduodenectomy (PD) is and it is carried out routinely at high-volume centers with mortality rates < 2% [3]. The symptoms of pancreatic cancer are nonspecific, such as abdominal pain, fatigue, nausea, weight loss and jaundice and may present themself late in the course of the disease and thereby the diagnosis is usually revealed in advanced stages, after locally invasions or systemic dissemination [4]. The etiology of pancreatic cancer is incompletely understood and the identification of the risk factors mainly the ones that are modifiable through behavioral change or medication, remains a point of interest in the study of this disease. The risk factors implicated in development of pancreatic cancer include family history, smoking, chronic pancreatitis, obesity and diabetes mellitus. Phthalates are commonly used in products such as cosmetics, soaps, pesticides, lubricants, plastics, and paints. Studies have also found associations between some phthalate metabolites and antiandrogenic effects in humans, including both infant and adult males. The researchers compared the levels of phthalates in the samples with the prevalence of chronic diseases in their subjects and also promote tumori genesis in a variety of cell types through AhR-mediated genomic and nongenomic pathways . They found that the men who had higher levels of phthalates had higher rates of cardiovascular disease, hypertension and type II diabetes .Finally, they adjusted the results to allow for differences in lifestyle, socioeconomic factors, and overweight and obesity. They found the results to still be significant [5, 6]. The relationship between pancreatic cancer and diabetes is complex and long debated. Various studies have revealed an increased risk of pancreatic cancer among patients with long-standing diabetes with a parallel increase in the prevalence of type 2 diabetes mellitus and in the incidence of PC. Population studies identified that about half of patients with pancreatic cancer have diabetes mellitus at the time of diagnosis. The factors implicated in development of pancreatic cancer appear to be the chronic metabolic and inflammatory repercussions of diabetes [7]. Recent studies indicated that roughly 20-30% of patients with pancreatic cancer developed diabetes in the 2 to 4 years prior to the neoplastic diagnosis [8, 9]. Hyperglycemia can be secondary to pancreatic tumor secret factors that cause paraneoplastic modification and recent onset diabetes will be treated by the surgical tumor resection [10]. In these theses we studied the relationship between pancreatic cancer and diabetes in order to assess if diabetes is cause or consequence of pancreatic neoplastic lesions.