胰腺癌与糖尿病关系的临床流行病学研究

目的探讨胰腺癌与糖尿病的流行病学关系。方法收集1991年至2004年间收治的508例胰腺癌病例;由同期非消化系统、非肿瘤及非激素代谢异常类的770例病例组成对照组。比较胰腺癌组内糖尿病患者及血糖正常者在性别、年龄、肿瘤部位、肿瘤分化程度方面的差异,并分层分析与对照组的差异。结果病例组内有和无糖尿病者性别、年龄无差异。不同胰腺癌部位及分化程度者糖尿病比例也无差异。病例组与对照组总体糖尿病发病率差异显著(33.465比8.83%,P<0.01,相对危险度=5.19),分层分析显示:糖尿病病程<2年者与>10年者的比例两组间差异有统计学意义(P<0.01,相对危险度=5.25;P<0.01,相对危险度=7.71)。结论糖尿病与胰腺癌之间有密切关系,可能是胰腺癌的早期临床表现之一,也可能是胰腺癌的危险因素。

Clinical epidemiology study on the relationship between pancreatic cancer and diabetes mellitus

Objective To investigate the relationship between pancreatic cancer and diabetes mel- litus (DM).Methods Five hundreds and eight patients with pancreatic cancer and 770 controls,who suffered from non-digestive tract,non-neoplastic or non-hormone-related disorders,were enrolled between 1991 to 2004.Patients in two groups matched for age and gender.Pancreatic cancer patients with or without DM were compared for their gender,age,location or differentiate degree of the cancer. The difference between pancreatic cancer patients and controls in their prevalence of DM were analyzed. Results There was no difference for gender and age between patients with or without DM.Pancreatic cancer patients with low differentiation had the same frequency of DM compare with those with middle or well differentiation (26.31%,33.97%,29.41%,respectively,P>0.05).DM was found in 170 patients with pancreatic cancer (33.46%) and in 68 controls (8.83%)(P<0.01).Significant difference was found in pancreatic cancer patients with DM diagnosed within 2 years or for more than 10 years (P<0.01,RR=7.71).Conclusion DM may be one of the early presentations of pancreatic cancer,as well as a possible risk factor for the tumor.