Ⅱ型糖尿病与结直肠癌的相关性研究

目的：探讨结直肠癌与Ⅱ型糖尿病的相关性,了解Ⅱ型糖尿病对结直肠癌的发病、围手术期并发症以及预后的影响。方法：选取2002年-2010年间经病理确诊的结直肠癌手术后患者256例,同时期的非肿瘤手术后患者372例作对照,比较两组年龄、性别、体重指数（body mass index,BMI）、病程、糖尿病病史、糖尿病家族史、并发症、肿瘤系列生化检查及环境因素如吸烟和饮酒等因素,同时还分析了结直肠癌的发生率,以及各组对手术后并发症和预后的影响。结果：结直肠癌患者中Ⅱ型糖尿病的患者发生率为30.1%;较非肿瘤患者高;其并发感染占6.6%。结论：多因素分析结果显示,结直肠癌与Ⅱ型糖尿病存在某种相关性,Ⅱ型糖尿病增加了感染机会,并且增加了结直肠癌的风险和结直肠癌根治手术后感染的风险。     

2 型糖尿病与结直肠癌关系的临床研究*

目的:探讨2 型糖尿病（T2DM）与结直肠癌发病和转移的关系。方法:收集广西医科大学第一附属医院2001年1 月至2006年12月间收治的结直肠癌患者852 例和非肿瘤患者940 例的临床资料。比较两组在性别、肿瘤部位、糖尿病病程和肝转移等方面的差异,并对相关危险因素进行分析。结果:T2DM患者结直肠癌发病的危险显著高于非T2DM 患者,其OR值为2.466,男性T2DM 患者发生结直肠癌的危险高于女性,差异无统计学意义（OR值2.775 vs 2.070,P=0.394）。 患有左半结肠癌的患者发生T2DM的比例最高,但与患有右半结肠癌和直肠癌者无显著性差异。T2DM病程在10～20年组发生结直肠癌的危险性最高,其OR值为4.696。T2DM合并结直肠癌患者发生肝脏转移危险性高于非T2DM合并结直肠癌患者,其OR值为2.888。结论:T2DM可能是结直肠癌发生的危险因素之一,在T2DM病程小于20年以内这种危险性随着病程的增加而增加;T2DM合并结直肠癌患者更容易发生肝脏转移。      

代谢综合征与结直肠癌相关性的研究进展

代谢综合征(MetS)是包括肥胖、糖尿病、高血压、血脂异常等多种代谢性疾病在内的一组临床综合征。MetS与结直肠癌(CRC)之间存在着多种共同的危险因素,近年来,越来越多的研究表明MetS不仅参与CRC的发生发展,且在其预后中也起着至关重要的作用。该文就MetS与CRC之间相关性的研究进展作一综述。     

糖尿病与结直肠癌发病及转移关系

[目的]了解糖尿病与结直肠癌发病及其转移的关系。[方法]采用病例对照的方法分析我院364例结直肠癌患者和非肿瘤患者733例与糖尿病的关系。[结果]糖尿病患者患结直肠癌的危险度是非糖尿病患者的1.72倍;有糖尿病史的结直肠癌患者发生转移的危险度是无糖尿病史的1.94倍;多因素Logistic回归分析显示：糖尿病史是结直肠癌患病的独立危险因素。[结论]糖尿病增加了患结直肠癌的风险性,并可加速结直肠癌的转移。     

EMT与Ⅱ期结直肠癌复发转移的相关性分析

目的探讨E-cadherin、vimentin与Ⅱ期结直肠癌(colorectal cancer,CRC)复发转移的关系。方法选取Ⅱ期结直肠癌复发转移与未复发转移患者的组织切片,采用免疫组化技术检测E-cadherin、vimentin的表达情况。结果 Ecadherin、vimentin表达与复发转移有关。结论 E-cadherin、vimentin可能作为Ⅱ期CRC复发转移的分子标志物。     

结直肠癌合并2型糖尿病患者FIB和D-dimer与临床病理特征相关性分析

目的 肿瘤患者体内凝血系统异常活化,而糖尿病患者体内也存在多种促凝和抗凝成分的改变.本研究探讨结直肠癌(colorectal cancer,CRC)合并2型糖尿病(type 2 diabetes mellitus,T2DM)以及单纯CRC患者血浆纤维蛋白原(fibrinogen,FIB)和D-二聚体(D-dimer)的变化,及FIB、D-dimer与CRC合并T2DM患者临床病理特征之间的关系.方法 选取2011-03-07-2015-09-25天津市人民医院住院患者1 141例.分为合并组274例和CRC组867例,合并组为CRC合并T2DM患者,CRC组为单纯CRC患者.检测空腹血糖(Glu)、FIB和D-dimer,比较两组差异.应用单因素方差分析和t检验比较患者不同临床病理特征FIB水平的差异,应用非参数检验比较患者不同临床病理特征D-dimer水平的差异.结果 合并组FIB水平为(4.16±1.066) g/L,高于CRC组的(3.96±0.935) g/L,t=-2.727,P=0.007;合并组D-dimer水平为0.38(0.26,0.67) mg/L,CRC组D-dimer水平为0.40(0.26,0.66) mg/L,两者比较差异无统计学意义,Z=0.168,P=0.867.合并组肿瘤长径≥5 cm者FIB (4.41±1.03) g/L高于肿瘤长径＜5 cm者(3.87±1.01) g/L,t=-3.946,P＜0.001;pT3-4期肿瘤患者FIB(4.21±1.04) g/L高于pT1～T2期的(3.78±1.01) g/L,t=-2.295,P=0.023;低、中分化患者FIB水平(4.70±1.00、4.20±1.03) g/L高于高分化患者(3.83±1.10) g/L,F=4.262,P=0.015.合并组女性D-dimer水平0.51(0.32,1.08) mg/L高于男性0.34(0.26,0.55) mg/L,Z=3.797,P＜0.001;结肠癌患者D-dimer水平0.47(0.31,0.78) mg/L高于直肠癌患者0.34(0.26,0.61) mg/L,Z=2.492,P=0.013;pT3～T4期患者D-dimer水平0.39(0.26,0.72) mg/L高于pT1～T2期者0.32(0.24,0.42) mg/L,Z=2.090,P=0.037.结论 CRC合并T2DM患者血液处于高凝状态.CRC合并T2DM患者术前高FIB和D-dimer水平与较大的肿瘤直径和较差的肿瘤病理分期、分化有关.     

脉管瘤栓在Ⅱ期结直肠癌中的临床价值研究

目的 探讨脉管瘤栓在Ⅱ期结直肠癌中的临床意义.方法 系统性搜集行手术治疗的Ⅱ期结直肠癌患者临床资料和随访资料,分析患者脉管瘤栓情况与临床特征的关系和其对预后的影响.结果 共纳入305例Ⅱ期结直肠癌病例,其中伴有脉管瘤栓者67例(22.0％).脉管瘤栓情况在年龄、分化程度、pT分期和神经侵犯情况方面比较,差异均具有统计学...     

2型糖尿病与结直肠癌关系的回顾性分析

目的探讨结直肠癌患者中伴发2型糖尿病的比例,比较合并糖尿病的结直肠癌患者与普通结直肠癌患者发生淋巴结或远处转移的比率,了解糖尿病是否为结直肠癌发病的重要危险因素,为做好结直肠癌的一级预防提供思路。方法回顾分析286例住院结直肠癌患者的血糖情况,计算2型糖尿病患病率,分别计算合并糖尿病的结直肠癌患者与普通结直肠癌患者发生淋巴结或远处转移的比率。结果结直肠癌患者中2型糖尿病的患病率为8．04％,标准化患病率为3．97％,与全国糖尿病标准化患病率比较差异有显著性（P〈0．01）;合并糖尿病的结直肠癌患者淋巴结或其他组织器官转移率为69．6％（16／23）,高于无糖尿病的结直肠癌患者（42．2％,111／263）。结论糖尿病与结直肠癌患病存在一定的相关性,糖尿病增加了患结直肠癌的风险性。预示2型糖尿病可能是结直肠癌发生的独立危险因素,加强糖尿病的防治将对预防结直肠癌患病和改善预后有重要的作用。     

结直肠癌发病风险与ABO血型分布的关系

目的:探讨结直肠癌患病风险与ABO血型分布的关系。方法:通过LinkDoc数据库（LinkDoc Data）抽取辽宁省肿瘤医院含有ABO血型信息的结直肠癌住院患者的数据2 333例,与本地区另一家三甲医院的血型样本（36 124例）对照,回顾性分析不同血型患结直肠癌的风险。结果:2 333例结直肠癌患者中,A型患者663例（28.42%）,AB型患者689例（29.53%）,B型患者721例（30.90%）,O型患者260例（11.14%）。与对照组比较,AB型较非AB型结直肠癌患病风险升高（OR=3.54,95%CI=3.219~3.893）,O型较非O型结直肠癌患病风险下降（OR=0.299,95%CI=0.262~0.341）。结论:结直肠癌患者ABO血型分布与对照人群ABO血型分布有明显差别,AB型人群较其它血型人群结直肠癌发生风险升高,而O型结直肠癌发生风险降低,血型可能是结直肠癌发生的危险因素之一,但是有地域差别,在本地区AB血型人群应该是结直肠癌重点筛查对象。     

结直肠癌根治术后并发静脉血栓栓塞的危险因素分析

目的 探究结直肠癌根治术后并发静脉血栓栓塞(VTE)的危险因素.方法 选择行结直肠癌根治术患者200例作为研究对象,根据患者是否发生VTE分为VTE组(16例)及非VTE组(184例),分析结直肠癌术后并发VTE的相关危险因素.结果 患者年龄≥60岁、男性、有VTE既往病史、呼吸系统疾病、心血管疾病、手术时间、术中出血...     

D-二聚体与胃癌合并2型糖尿病临床病理特征相关性分析及对其预后的影响

目的:探讨胃癌合并2型糖尿病(type 2 diabetes mellitus,T2DM)患者与单纯胃癌患者血浆D-二聚体水平的变化,血浆D-二聚体水平与胃癌合并T2DM患者临床病理特征的关系及对其预后的影响.方法:回顾性收集2010年9月至2018年10月于郑州大学第一附属医院就诊的996例胃癌患者的临床资料.根据是...     

The prognostic role of fasting plasma glucose levels on survival in advanced colorectal cancer patients with type II diabetes mellitus: a retrospective cohort study

BackgroundPrevious studies have shown that type II diabetes mellitus (T2DM) has a significant effect on the occurrence and development of colorectal cancer (CRC). The associations between fasting plasma glucose (FPG) and overall survival (OS) of CRC patients with T2DM are still controversial. The present study sought to examine the association between FPG control and OS in advanced CRC patients with T2DM.MethodsThe data of advanced CRC patients with T2DM who were admitted to Harbin Medical University Cancer Hospital from May 2010 to May 2019 were retrospectively collected and examined. Record patient clinical data including age, sex, blood pressure, body mass index (BMI), primary tumor site, T stage, N stage, histological grade, number of metastatic sites, primary tumor surgery, etc. The baseline FPG which was measured before the first-line treatment and the FPG measured before each admission treatment during advanced chemotherapy were collected. OS was determined as the end point of the study. All the patients were followed-up for at least 3 years. The Kaplan-Meier log-rank method and the Cox proportional hazards regression analyses were used for the analysis of OS and hazard factors.ResultsA total of 210 patients met the inclusion criteria for the study, who had a median age of 66.5 years; 94 patients had baseline FPG levels ≤7 mmol/L, and 116 patients had baseline FPG levels >7 mmol/L. Compared to the baseline FPG >7 mmol/L group, the OS of patients in the baseline FPG ≤7 mmol/L group was not significantly prolonged (P=0.88). There were 52 patients in the FPG-A group and 61 in the FPG-B group. Similarly, there was no significant difference in OS between the FPG-A and FPG-B groups (P=0.96). The N0 stage subgroup analysis showed that glycemic control ≤7 mmol/L resulted in longer OS.ConclusionsThe results of the present study showed that FPG levels may not affect the survival of advanced CRC patients with T2DM. However, this needs multicenter prospective studies to confirm.     

Cancer risk in patients with type 2 diabetes mellitus and their relatives

Epidemiological studies indicate that risks of certain cancers are increased in individuals hospitalized for type 2 diabetes mellitus (T2DM), which may not be representative of the entire population of T2DM patients as most of them are treated in primary health cares. To examine the subsequent cancer risk in individuals with T2DM from hospitals and primary health cares, and in their siblings and spouses, standardized incidence ratios (SIRs) were used to assess systematically risks of 35 cancer sites/types in individuals with T2DM using a nationwide Swedish database covering the period 1964 through 2010. Increased SIRs were recorded for 24 cancer sites/types in individuals with T2DM. The highest SIRs were for pancreatic cancer and liver cancer (2.98 and 2.43, respectively). A decreased SIR was noted for prostate cancer. Five cancers showed increased SIRs during the whole follow‐up period: colon, liver, pancreatic, endometrial and kidney cancers. T2DM patients in inpatient, outpatient and primary health care showed similar risk patterns. The overall SIRs for cancer in the siblings and spouses of individuals with T2DM were 0.97 and 1.01, respectively. The insulin users showed an overall increased risk of cancer. This study showed increased risks of 24 cancers in individuals with T2DM, but not in their siblings or spouses, suggesting that the profound metabolic disturbances of the underlying disease may explain the observed increases. Further studies examining the endogenous and exogenous factors underlying these associations are needed.     

The effects of metformin on the survival of colorectal cancer patients with diabetes mellitus

Metformin use has been associated with decreased cancer risk and mortality. However, the effects of metformin on clinical outcomes of colorectal cancer (CRC) are not defined. This study aimed to evaluate the association between metformin use and mortality of CRC in diabetic patients. We identified 595 patients who were diagnosed both CRC and diabetes mellitus. Patients were compared by two groups; 258 diabetic patients taking metformin and 337 diabetic patients not taking metformin. Patient's demographics, clinical characteristics, overall mortality and CRC-specific mortality were analyzed. After a median follow-up of 41 months, there were 71 total deaths (27.5%) and 55 CRC-specific deaths (21.3%) among 258 patients who used metformin, compared with 136 total deaths (40.4%) and 104 CRC-specific deaths (30.9%) among 337 patients who did not use metformin. Metformin use was associated with decreased overall mortality (p = 0.018) and CRC-specific mortality (p = 0.042) by univariate analysis. After adjustment for clinically relevant factors, metformin use showed lower risk of overall mortality (HR, 0.66; 95% CI 0.476-0.923; p = 0.015) and CRC-specific mortality (HR, 0.66; 95% CI 0.45-0.975; p = 0.037) in CRC patients with diabetes. Metformin use in CRC patients with diabetes is associated with lower risk of CRC-specific and overall mortality.     

2型糖尿病患者血清糖化血红蛋白水平与甲状腺癌发病风险的关系

目的:检测2型糖尿病（T2DM）患者血清糖化血红蛋白（HbA1c）水平,探讨血清HbA1c水平与甲状腺癌发病风险的关系。方法:选取2017年1月至2019年6月在本院收治的T2DM患者（观察组）328例作为研究对象,其中未并发甲状腺癌T2DM患者（未并甲状腺癌组）297例,并发甲状腺癌T2DM患者（并甲状腺癌组）31例,选取同期健康体检者（对照组）330例作为对照。采集受试者清晨空腹外周血并提取血清,全自动生化分析仪检测血清HbA1c、总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）以及低密度脂蛋白胆固醇（LDL-C）水平;Pearson法分析T2DM患者血清HbA1c水平与TC、TG、HDL-C、LDL-C水平的相关性;采用多因素Logistic回归分析影响T2DM患者并发甲状腺癌的因素。结果:与对照组相比,观察组T2DM患者血清HbA1c、TC、TG、LDL-C水平、甲状腺癌发病率均明显升高（P<0.05）,HDL-C水平明显降低（P<0.05）;T2DM患者血清HbA1c水平与TC、TG水平明显正相关（P<0.05）,与HDL-C水平明显负相关（P<0.05）;与未并甲状腺癌组相比,并甲状腺癌组T2DM患者血清HbA1c、TC、TG水平明显升高（P<0.05）,HDL-C水平明显降低（P<0.05）,LDL-C水平无明显变化（P>0.05）;血清HbA1c、TC、TG水平均为影响T2DM患者并发甲状腺癌的危险因素（P<0.05）,血清HDL-C水平为影响T2DM患者并发甲状腺癌的保护因素（P<0.05）。结论:T2DM患者并发甲状腺癌可能与血清HbA1c水平升高有关,HbA1c可能通过调控血脂水平,增加T2DM患者并发甲状腺癌的风险,可作为临床上判断T2DM患者并发甲状腺癌风险的依据。     

合并2型糖尿病的乳腺癌患者临床病理特征及预后分析

目的:分析合并2型糖尿病乳腺癌患者的临床病理学特征及其与预后的关系。方法:收集西安交通大学第二附属医院肿瘤科2012年1月至2014年12月收治的合并2型糖尿病的乳腺癌患者102例作为糖尿病组,按照1∶2的原则选取同期就诊于西安交通大学第二附属医院肿瘤科的非糖尿病乳腺癌患者204例作为对照组,比较两组临床病理特征以及预后。结果:糖尿病组相比对照组,糖尿病组50岁以上人群比率显著高于对照组（76.5% vs 57.8%,P<0.05）,糖尿病组绝经后患者的比率显著高于对照组（69.6% vs 53.9%,P<0.05）;糖尿病组和对照组相比,其中T2期及以上患者所占比例（79.4% vs 66.2%）、淋巴结阳性患者比例（68.6% vs 55.4%）、Ⅱ/Ⅲ期患者所占比例（82.8% vs 67.6%）糖尿病组更高,差异具有统计学意义（P<0.05）。糖尿病组5年复发转移率为14.9%。结论:2型糖尿病是乳腺癌发生发展和淋巴结转移的不良危险因素,乳腺癌合并2型糖尿病患者的病理T分期和临床分期偏晚,淋巴结转移更多,其复发转移率较高,合并2型糖尿病的乳腺癌患者可能预后更差,应更加注重术后定期复查及随访。     

Association between serum urea concentrations and the risk of colorectal cancer,particularly in individuals with type 2 diabetes: A cohort study

Dysregulation of the urea cycle (UC) has been detected in colorectal cancer (CRC). However, the impact of the UC's end product, urea, on CRC development remains unclear. We investigated the association between serum urea and CRC risk based on the data of 348 872 participants cancer-free at recruitment from the UK Biobank. Multivariable Cox proportional hazards models were fitted to conduct risk estimates. Stratification analyses based on sex, diet pattern, metabolic factors (including body mass index [BMI], the estimated glomerular filtration rate [eGFR] and type 2 diabetes [T2D]) and genetic profiles (the polygenic risk score [PRS] of CRC) were conducted to find potential modifiers. During an average of 9.0 years of follow-up, we identified 3408 (1.0%) CRC incident cases. Serum urea showed a nonlinear relationship with CRC risk (P-nonlinear: .035). Lower serum urea levels were associated with a higher CRC risk, with a fully-adjusted hazard ratio (HR) of 1.26 (95% confidence interval [CI]: 1.13-1.41) in the first quartile (Q1) of urea, compared to the Q4. This association was largely consistent across subgroups of sex, protein diet, BMI, eGFR and CRC-PRSs (P-interaction >.05); however, it was stronger in the T2D, with an interaction between urea and T2D on both additive (synergy index: 3.32, [95% CI: 1.24-8.88]) and multiplicative scales (P-interaction: .019). Lower serum urea concentrations were associated with an increased risk of CRC, with a more pronounced effect observed in individuals with T2D. Maintaining stable levels of serum urea has important implications for CRC prevention, particularly in individuals with T2D.