摘要
目的调查新诊断恶性肿瘤患者中糖尿病患病率，评估合并糖尿病患者与未合并糖尿病患者在肿瘤分期、治疗和生存率等方面的差异，研究糖尿病与肿瘤的相关性。方法回顾性调查16890例新诊断恶性肿瘤患者中合并糖尿病与未合并糖尿病患者的肿瘤分期、治疗和远期生存情况、伴随疾病等，并进行比较。结果9．57％的肿瘤患者在初次诊断时患糖尿病，胰腺癌、肾癌、结肠直肠癌、子宫内膜癌患者中糖尿病患病率较高，依次为18．76％、16．76％、12．34％、10．97％。合并糖尿病的结肠癌患者在初次诊断时肿瘤分期较晚。多因素logistic回归分析表明，合并糖尿病的结肠癌、胃癌、子宫内膜癌患者在治疗上更多选择手术治疗。除前列腺癌外，合并糖尿病的肿瘤患者的总体死亡率均明显高于未合并糖尿病者，其中位生存时间、3年生存率均明显低于未合并糖尿病患者（P〈0．05）。经校正心血管疾病的影响后，合并糖尿病的结肠直肠癌、乳腺癌、子宫内膜癌、卵巢癌、前列腺癌、肾癌、非小细胞肺癌等患者死亡风险高于未合并糖尿病患者8％～55％（P〈0．05）。结论糖尿病人群的恶性肿瘤患病率较高，且肿瘤分期较晚，治疗效果较差，预后不良。
Objective To evaluate the influence of diabetes on cancer stage, treatment, and overall survival rate among newly diagnosed cancer patients, and the correlation between diabetes mellitus and cancer. Methods Total 16 890 newly diagnosed cancer patients were analyzed retrospectively. Morbidity rate of diabetes mellitus, stage of cancer, cancer treatment, survival rate, and comorbidities were collected and compared. Results 9.57% of those 16 890 cancer patients were suffering from diabetes by the time of cancer diagnosis. The prevalence of diabetes was high among patients with pancreas cancer （ 18.76% ）, renal cancer （ 16.76% ）, colorectal cancer （ 12.34% ）, and uterine cancer （ 10.97% ）. Colorectal cancer was often diagnosed at an advanced tumor stage. Compared with those without diabetes, diabetic patients with colorectal cancer, gastric cancer, and endometrial carcinoma were more likely to receive surgical treatment. Unadjusted analyses showed that the median survival time and percent alive at 3 years in cancer patients with diabetes were significantly reduced in all types of cancers, except for prostate cancer, as compared with those cases without diabetes. After adjustment for occurrence of cardiovascular disease, diabetic patients with colorectal, breast, endometrial, ovary, prostate, kidney, and lung cancers still had a 8%-55% increased risk of mortality compared to cancer patients without diabetes mellitus （P〈 0.05）. Conclusion The prevalane of cancer in diabetes is higher than non-diabetics. Diabetic cancer patients are frequently treated less aggressively and have a worse prognosis compared to those without diabetes.
出处
《中华内分泌代谢杂志》
CAS
CSCD
北大核心
2010年第3期183-187,共5页
Chinese Journal of Endocrinology and Metabolism
关键词
恶性肿瘤
糖尿病
治疗
相关性
Cancer
Diabetes mellitus
Treatment
Correlation
