糖尿病与结直肠癌及其生物学行为的关系

目的探讨糖尿病与结直肠癌发生及生物学行为的关系。方法对2006—2009年南方医科大学附属南海人民医院486例结直肠癌患者（结直肠癌组）与533例同期收治的非结直肠癌患者（对照组）进行病例对照研究，比较两组患者糖尿病并发情况及糖尿病病程对结直肠癌发生的影响。并对结直肠癌组患者中合并糖尿病对肿瘤生物学行为的影响进行分析。结果结直肠癌组和对照组的糖尿病并发率分别为12．1％（59／486）和7．1％（38／533），差异有统计学意义（P〈0．01）；进一步经多因素分析结果显示．糖尿病是结直肠癌发生的独立危险因素（OR=1．886，95％CI：1．450．3．571）。糖尿病病程5。20年者结直肠癌发生危险性显著升高（P〈0．05）．而病程5年以内或超过20年者，其结直肠癌发生风险未见增高（P〉0．05）。结直肠癌患者是否并发糖尿病对肿瘤分化程度、浸润深度、淋巴结转移、远处转移及脉管栓塞均无明显影响（P〉0．05）。结论糖尿病患者罹患结直肠癌的风险增高．但并发糖尿病并不会改变结直肠癌的肿瘤生物学行为。

Association of diabetes mellitus with biological behaviors of colorectal cancer

Objective To evaluate the association of diabetes mellitus (DM) with colorectal cancer. Methods Case-control study was performed to compare 486 patients with colorectal cancer (study group) and 533 patients without colorectal cancer (control group) in the Affiliated Nanhai Hospital of Southern Medical University between 2006 and 2009. Results The incidence of DM was 12.1% in study group and 7.1% in the control group, and the difference was significant (P＜0.01). On multivariate analysis, DM was independently associated with colorectal cancer (OR=1.886,95% CI:1.450～3.571 ). Colorectal cancer risk was increased in DM patients with a duration of 5-20 years (P＜0.05), while colorectal cancer risk in those with a duration less than 5 years or more than 20 years did not change (P＞0.05). No significant differences in tumor differentiation, invasion depth, lymph node involvement, distant metastasis and lymphovascular invasion were found between colorectal cancer patients with and without DM (all P＞0.05). Conclusion Diabetes mellitus increases the risk of colorectal cancer, however, biological behaviors of colorectal cancer is not associated with diabetes mellitus.