胰腺癌患者危险因素及其临床意义分析

目的 探讨胰腺癌(PC)患者危险因素及其临床意义.方法 回顾性分析重庆医科大学附属第一、二医院近10年936例PC患者临床资料,收集同期年龄、性别匹配的未合并肿瘤、消化系统及激素代谢异常类疾病患者832例为对照组,分析两组性别、年龄、糖尿病(DM)发病率及病程、降糖药物类别、BM I,以及胰腺炎病史、PC家族史、DM 家族史的区别及相关性.结果PC组中男性多于女性,且随年龄增加男性比例更高;PC组中合并DM 251例(26.8%),明显高于对照组DM 的发病率13.0%(P<0.01);PC组中新发DM高达14.1%(132/936),明显高于对照组3.4%(P<0.01).PC家族史、胰腺炎病史、DM家族史、超重和肥胖是PC发生的独立危险因素,新发DM患者PC发生风险升高4.9倍,二甲双胍可降低 PC发生风险.二甲双胍组确诊DM至PC发生时间最长(18.86 ± 3.46)个月,未用药组时间最短(6.44 ± 1.07)个月.结论 伴DM家族史、PC家族史、胰腺炎病史、超重及肥胖的新发DM患者应警惕PC发生,二甲双胍可能具有延缓新发DM患者PC发生、发展的作用.

Analysis on risk factors and clinical significance in patients with pancreatic cancer

Objective To investigate the risk factors and clinical significances in the patients with pancreatic cancer(PC). Methods The clinical data of 936 patients with PC in the Affiliated Hospital of Chongqing Medical University during the past 10 years were retrospectively analyzed,and contemporaneous 832 age and sex-matched cases of non-complicating tumor and disease of digestive system and metabolic abnormality were collected as the control group.The differences and correlation between the two groups were analyzed retrospectively,including the gender,age,incidence and course of diabetes mellitus(DM),category of hypogly-cemic drugs,body mass index(BMI),history of pancreatitis,family history of PC and family history of diabetes.Results (1)There were more males than females in PC group,moreover the male proportion was much higher than the female proportion with the age growing.In the PC group,251 cases(26.8%)were complicating DM,which was significantly higher than 13.0% of DM occurrence rate in the control group(P<0.01);in the PC group,new onset DM was up to 14.1%(132/936),which was obviously higher than 3.4% in the control group(P<0.01).The family history of PC,history of pancreatitis,family history of diabetes,overweight and obesity were the independent risk factors for PC.The risk of PC in new-onset DM patients was increased by 4.9 times.Metformin could decrease the risk of developing PC.The time from diagnosed DM to PC in the metformin group was longest[(18.86 ± 3.46) months],which in the non-medication group was shortest[(6.44 ± 1.07)months].Conclusion New-onset DM patients with fami-ly history of DM,family history of PC,history of pancreatitis,overweight and obese should be vigilant to develop PC.For the new-onset DM patients,anti-diabetic drugs influence the onset time of PC and metformin may have effect to delay the occurrence and de-velopment of PC.