胰腺癌与糖尿病的流行病学研究

目的 探讨胰腺癌与糖尿病的流行病学关系.方法 收集1997年至2007年间收治的220例胰腺癌病例,以同期非消化系统、非肿瘤及非代谢异常类的300例患者作为对照组.比较两组糖尿病的发病率、糖尿病病程与胰腺癌的关系;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、肿瘤分化程度等方面的差异.结果 胰腺癌组和对照组糖尿病发病率分别为33.2%和9.7%.差异显著(P<0.05).胰腺癌组糖尿病病程<2年与≥10年者的比例分别为78.1%(57/73)和9.6%(7/73),显著高于对照组的62.1%(18/29)和6.9%(2/29),两组比较有统计学差异(χ2=46.15,P<0.01,OR=6.07;χ2=4.72,P<0.01,OR=4.90);胰腺癌组糖尿病病程2～<5年及5～<10年者比例与对照组无显著差异.胰腺癌组内糖尿病患者和非糖尿病患者性别、年龄、肿瘤部位比较差异无显著性,但糖尿病者肿瘤分化以乳头状或高分化腺癌为主,而无糖尿病者肿瘤以低分化腺癌为主.结论 糖尿病与胰腺癌关系密切,可能是胰腺癌的临床表现之一,也可能是胰腺癌的危险因素.

An epidemiology study of the relationship between pancreatic cancer and diabetes mellitus

Objective To investigate the relationship between pancreatic cancer and diabetes mellitus (DM). Methods Two hundreds and twenty patients with pancreatic cancer and 300 controls, who suffered from non-digestive tract, non-neoplastic or non-hormone-related disorders, were enrolled from 1997 to 2007. The incidence of diabetes between the two groups and the relationship between pancreatic cancer and diabetes were compared, pancreatic cancer patients with DM were compared with patients without DM for their gender, age, location and differentiate degree of the cancer. Results The incidence of DM in the two groups were 33.1% and 9.67%, respectively, and the difference was significant (P < 0.05). In the pancreatic cancer group, the proportion of patients with DM diagnosed within 2 years or for more than 10 years were 25.91% (57/73) and 3.18% (7/73), which were significant higher than those in the control group 6.0% (18/29) and 0.67% (2/29)) (χ2=46.15, P<0.01, 0R=6.07; χ2 =4.72, P<0.01, OR=4.90). In the pancreatic cancer group, the proportion of patients with DM diagnosed within 2～5 years or 5～10 years was not significant different when compared with that of the control group, and there was no significant difference in terms of gender, age and cancer location between the pancreatic cancer patients with DM and without DM. The majority of pancreatic cancer patients with DM had corpora mammillaria or well differentiated adenocarcinoma, and the majority of pancreatic cancer patients without DM had differentiated adenocarcinoma. Conclusions DM was closely related with pancreatic cancer and DM may be one of the presentations of pancreatic cancer, as well as a possible risk factor for the tumor.