胃癌合并2型糖尿病患者临床特征及预后分析

目的： 探讨胃癌患者合并2型糖尿病的临床特征，分析糖尿病对胃癌患者预后的影响。方法：对2003年1月至2011年7月期间我院收治的胃癌患者的临床病例资料进行回顾性分析，共纳入252例患者，按照是否存在糖尿病将胃癌患者分为合并糖尿病组（85例）和未合并糖尿病组（167例），比较两组患者的临床特征，分析两组患者的总生存率。结果：两组患者在性别、年龄、文化程度、发病部位、手术方式等方面差异无统计学意义（P>0.05），但两组的分化程度、肿瘤分期存在差异（P<0.05），合并糖尿病组患者的肿瘤分化程度较低。合并糖尿病组总体中位生存期为43.8个月，5年生存率为30.5%；未合并糖尿病组总体中位生存期为58.2个月，5年生存率为41.4%；经Log rank检验两组患者总生存率比较差异有统计学意义（χ2=10.076，P=0.002）。糖尿病、分化程度、临床分期是影响胃癌患者生存的独立影响因素。结论：2型糖尿病可影响胃癌患者的预后，糖尿病与胃癌预后的关系有待更深入的研究。

Investigation and Analysis on Clinical Features and Prognosis of Patients with Diabetes Mellitus and Gastric Cancer

Objective:Investigating the correlation between Type 2 Diabetes Mellitus (T2DM) and Gastric Cancer (GC) to evaluate the impact of T2DM on prognosis of patients with GC.Methods:Clinical data of 252 GC patients during January 2003 to July 2011 was collected,including 85 GC patients with T2DM and 167 patients without T2DM.KaplanMeier analysis and log-rank test were used to calculate the over-all survival rate of the two groups.Results:There were no significant differences in sex,age,education levels,disease locations,operation methods between two groups,but the degrees of differentiation and clinical stages between two groups were different,GC patients with T2DM had a lower degree of tumor differentiation.The median overall survival for GC patients with T2DM was 43.8 months,and 5-year overall survival rate was 30.5％.The median overall survival for GC patients without T2DM was 58.2 months,and 5-year overall survival rate was 41.4％.Log-rank test showed that the overall survival rate of the two groups was statistically significant.The COX regression analysis showed that DM,the degrees of differentiation and clinical stages were independent prognostic factor for overall survival.Conclusion:Type 2 diabetes mellitus can influence the prognosis of GC patients,and furthermore research needs to be done to reveal the correlation between DM and GC.