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.     

2型糖尿病对原发性肝癌发病的危险性分析

目的 明确糖尿病是否为原发性肝癌发病的危险因素.方法 采用病例对照研究的方法将原发性肝癌848例分为糖尿病组和非糖尿病组,分析糖尿病对原发性肝癌患病率的影响.结果 合并糖尿病的男性患者患原发性肝癌的OR值为11.78,女性患者OR值为8.21,男女性别间比较无显著性差异.糖尿病病程小于5年者患原发性肝癌的OR值为3.42,病程5～10年者OR值为13.83,病程大于10年者OR值为17.80.有糖尿病史但不嗜酒且无病毒性肝炎者患原发性肝癌的OR值为2.61,有糖尿病史合并病毒性肝炎但不嗜酒者OR值为11.84,有糖尿病史、嗜酒但无病毒性肝炎者OR值为5.51,有糖尿病史、嗜酒且合并病毒性肝炎者OR值为14.91,合并糖尿病的肝硬化患者发生原发性肝癌的OR值为2.38.结论 患糖尿病人群中原发性肝癌的发病率明显增加,且随着糖尿病病程增加,患病危险性增加,但在男女性别之间无明显差异.糖尿病是原发性肝癌的独立危险因素,与病毒性肝炎、嗜酒、肝硬化等因素之间有协同作用.     

2型糖尿病与消化系统恶性肿瘤关系的临床研究

目的探讨2型糖尿病与消化系统恶性肿瘤的临床研究。方法以2013年1月至2015年9月海淀医院消化内科收治的1 740例糖尿病患者为糖尿病组。选择同期其他科室年龄和性别相似的非糖尿病病人1 500例为非糖尿病组。其中糖尿病组又分为消化系统恶性肿瘤组(86例)和非消化系统恶性肿瘤组(58例)。分析2型糖尿病对消化系统肿瘤患病率的影响。结果糖尿病合并肝癌、直肠癌和胰腺癌的患病率4.94%(86例)均显著高于非糖尿病合并消化系统恶性肿瘤的患病率2.00%(30例),差异有统计学意义(P0.05);消化系统恶性肿瘤组FPG(7.91±2.30)mmol/L、CA199(146.52±279.60)U/m L均高于非消化系统恶性肿瘤组的(5.57±1.40)mmol/L、(22.44±25.68)U/m L,差异均有统计学意义(P0.05)。糖尿病患者患肝癌的OR值为2.21,患结直肠癌的OR值为2.11,患胰腺癌的OR值为5.51(P均0.05)。结论 2型糖尿病患者患结直肠癌、胰腺癌、肝癌等消化系统肿瘤的发病率明显增加。2型糖尿病可能是胰腺癌的首发症状,同时也可能是肝癌独立危险因素之一。     

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。     

非新发Ⅱ型糖尿病（病程〉2年）与胰腺癌的关系探讨

目的探讨非新发Ⅱ型糖尿病（病程〉2年）与胰腺癌的关系。方法采取回顾性病例一对照研究方法,选取我院2000年1月-2011年5月收治的77例胰腺癌患者为病例组,另按照一定标准选取2010年1月-2011年5月在我院骨科住院的83例为对照组,记录每例患者血糖情况,然后进行统计分析。结果病例组中非新发Ⅱ型糖尿病（病程〉2年）者18例;对照组中非新发Ⅱ型糖尿病（病程〉2年）者12例,两组非新发糖尿病比例差异无统计学意义（P=0．2144）。结论非新发Ⅱ型糖尿病（病程〉2年）并不增加罹患胰腺癌的危险。     

不同时期胰腺癌易感因素分析与比较

目的　分析胰腺癌患者易感因素 ,以期能确认胰腺癌危险因素。方法　采用回顾性分析的方法 ,分析 1985年 10月～ 1991年 11月 (78例 )及 1995年 10月～ 2 0 0 1年 8月 (194例 )胰腺癌病例。结果　胰腺癌的发病率有逐年增高趋势 ;患者发病年龄以中老年为主 ,男性多见 ,且发病人数呈上升趋势 ;胰腺癌的易感因素依次为吸烟 (33.1% )、饮酒 (2 1.7% )、糖尿病 (11.8% )及慢性胰腺炎 (4.8% )等。1995～ 2 0 0 1年间患者有吸烟 (36 .6 % )、饮酒 (2 4 .7% )、糖尿病 (14 .9% )等病史者较 1985～ 1991年间有增加趋势 ,其中仅糖尿病 (3.8% )增加比率差异有显著性 ;随着吸烟量及年限增加 ,胰腺癌发病率有增加趋势 ;糖尿病胰腺癌组和非糖尿病胰腺癌组相比 ,肿瘤大小、部位、肿瘤切除率差异无显著性 ,但糖尿病组以高中分化腺癌为主 ,非糖尿病组低分化腺癌患者较多 ,两组之间相比差异有显著性 (P <0 .0 5 )。结论　吸烟、吸烟量与时间的长短与胰腺癌发生直接相关 ,合并糖尿病的胰腺癌者高分化腺癌比例明显高于未合并糖尿病者。胰腺癌的易感因素近期较以往亦增加。     

我国胰腺癌与糖尿病关系病例对照研究的荟萃分析

目的系统评价我国居民糖尿病(diabetes mellitus,DM)与胰腺癌的关系,为胰腺癌的早期诊断提供依据。方法检索Pub Med、中国科技期刊数据库、万方数据库中有关我国居民胰腺癌与DM关系的病例对照研究。2名评价者对入选研究的试验设计、研究对象特征及质量评价等进行独立摘录,并采用Stata 12.0软件进行荟萃分析。结果共纳入21篇相关文献,胰腺癌患者中DM发病的OR=3.89(95%CI:3.19~4.74,P0.00001)。根据DM病程进行亚组分析,DM病程2年的OR=5.540(95%CI:4.460~6.880,P0.05);DM病程2~5年的OR=1.933(95%CI:1.295~2.886,P0.05);DM病程5~10年的OR=1.982(95%CI:1.392~2.820,P0.05);DM病程10年的OR=2.518(95%CI:0.771~8.223,P0.05)。结论胰腺癌与DM之间存在相关性,然而随着DM病程逐渐延长,两者之间的关联逐渐减弱,DM病程10年以上,两者之间并无相关性。所以就我国居民而言,DM可能只是胰腺癌的早期症状。     

2型糖尿病患者胰腺MRI扩散加权成像初步分析

目的研究并探讨磁共振(Magnetic resonance imaging,MRI)扩散加权成像(Diffusion weighted imaging,DWI)在2型糖尿病患者胰腺检查中的应用价值。方法选择2014年1月—2017年9月期间在该院住院部接受治疗的150例2型糖尿病患者与同期在该院门诊接受健康体检的60名健康志愿者(对照组),对其实施胰腺DWI检测,测定其表观扩散系数(Apparent diffusion coefficient,ADC),比较不同病程患者的ADC值,分析2型糖尿病病程与ADC值的相关性。以穿刺病理活检诊断结果为参照,计算DWI对2型糖尿病合并胰腺癌的诊断灵敏度、特异度、准确性,分析诊断结果之间的一致性,再比较胰腺癌组患者、无胰腺癌组患者、对照组在不同b值下的ADC值。结果在b值分别为600、800、1 000 s/mm2时,2年组、2~10年组、10年组的ADC值比较均差异有统计学意义(P0.05),而经相关性分析发现,ADC值与2型糖尿病病程呈负相关。DWI对2型糖尿病合并胰腺癌的诊断灵敏度、特异度、准确性分别为95.12%、94.50%、94.67%,其诊断结果与穿刺病理活检诊断结果之间的一致性良好(Kappa=0.723),胰腺癌组、无胰腺癌组、对照组在不同b值下的ADC值比较均差异有统计学意义(P0.05)。结论胰腺DWI检查可对2型糖尿病早期胰腺癌病变予以准确检出,可作为2型糖尿病患者早期胰腺癌的重要筛查手段。     

我国西北地区代谢因素与胰腺癌的相关性

目的:探讨中国西北地区汉族人群代谢因素与胰腺癌的相关性,为胰腺癌防治提供新策略.方法:以2008-2014年就诊于西安交通大学第二附属医院的384例胰腺癌患者作为病例组,采用同期就诊于西安交通大学第二附属医院的744例与病例组患者性别、年龄相匹配的非肿瘤、非代谢性相关疾病的住院患者作为对照组.用病例对照研究的方法计算比值比(odds ratio,OR)及95%可信区间(confidence interval,95%CI),分析代谢综合征各因素与胰腺癌的相互关系,包括代谢综合征的高血压、高血糖、高脂血症、肥胖4个方面.结果:与同期非肿瘤、非代谢性相关疾病的住院患者相比,汉族人群高血糖为胰腺癌的危险因素,OR值及95%CI为1.74(1.49-2.03);高血压可能为胰腺癌的保护因素,但结果无统计学意义;在单因素分析时,肥胖及高血脂也为胰腺癌的危险因素(P0.05),OR值分别为1.49和1.99,但在进一步进行多因素分析时,高血脂与胰腺癌发病的相关性并无统计学意义.对代谢综合征各因素在胰腺癌患者中的分布特点进行分析时发现,与对照组患者相比,胰腺癌患者中同时存在3种或3种以上代谢紊乱的患者比例较高,差异具有统计学意义(P0.05).结论:与非肿瘤、非代谢性相关疾病患者相比,我国西北地区汉族人群中高血糖可能为胰腺癌的危险因素,高脂血症及肥胖与胰腺癌虽然在单因素分析中呈现相关性,但需要进一步的研究证实;与非肿瘤、非代谢性相关疾病患者相比,胰腺癌患者中同时存在3种或3种以上代谢紊乱的比例较高.     

住院老年2型糖尿病患者微血管病变的相关因素分析

目的探讨老年2型糖尿病患者微血管病变的构成比及相关因素。方法用回顾性分析的方法研究2003年～2010年于卫生部北京医院住院治疗的年龄≥60岁的2型糖尿病患者876例,分为糖尿病肾病(DN)组和非糖尿病肾病(非DN)组,糖尿病视网膜病变(DR)组和非糖尿病视网膜病变(非DR)组,糖尿病周围神经病变(DPN)组和非糖尿病周围神经病变(非DPN)组,计算DN、DR、DPN构成比,比较患者的临床特点,并探寻老年2型糖尿病患者DR、DN、DPN的相关因素。结果 (1)DN构成比为34.5%,DR构成比为42.4%,DPN构成比为82.3%。(2)DN与非DN两组间体质量指数(BMI)、糖尿病病程、高血压病程、收缩压(SBP)、舒张压(DBP)、空腹血糖(FBS)、糖化血红蛋白(HbA1c)、空腹胰岛素(Fins)、高密度脂蛋白胆固醇(HDL)、甘油三酯(TG)、尿酸(UA)均有显著性差异(P<0.05或P<0.01);DR与非DR两组间仅糖尿病病程、SBP、空腹C肽(FCP)有显著性差异(均P<0.01);DPN与非DPN两组间年龄、糖尿病病程、HbA1c、TC、LDL有显著性差异(P<0.05或P<0.01)。(3)Logistic回归结果显示,DN与SBP、HbA1c、FBS、HDL、UA、糖尿病病程有关(OR值分别为1.022、1.098、1.075、0.501、1.004,1.048,P<0.05或P<0.01);DR与SBP、HbA1c、糖尿病病程有关(OR值分别为1.017、1.102、1.097,P<0.05或P<0.01);DPN与HbA1c、LDL、糖尿病病程、年龄有关(OR值分别为1.226、1.370、1.041、1.058,P<0.05或P<0.01)。结论对于老年2型糖尿病患者,DN、DR、DPN均与糖尿病病程和HbA1c有关,控制血糖对防治微血管病变意义重大,综合控制血糖、血压、血脂、尿酸可以更好的防治糖尿病微血管并发症。     

Risk factors for pancreatic cancer in Orientals

In order to assess what the risk factors for patients with pancreatic cancer (PC) in Taiwan are, a retrospective study was undertaken among 282 consecutively enrolled inpatients with confirmed pancreatic cancer within the past 5 years. For comparison, 282 age- and sex-matched controls were consecutively enrolled. A history of smoking, consumption of alcohol, diabetes mellitus, cholecystectomy and gastric surgery were thoroughly reviewed. Smoking and diabetes mellitus were very common among patients with pancreatic cancer compared with controls (P< 0.01). A significant linear trend towards an increased odds ratios (OR) for the development of PC with a higher level of smoking was seen (P<0.001). Diabetes mellitus (DM) also exhibited an increased risk (OR: 2.84; P<0.01), while this risk still existed among those patients who had a diabetic history of more than 3 years. Among 129 histologically established PC patients, smoking remained as a risk factor for PC, while the linear trend with an increasing OR with increasing levels of smoking was confirmed again (P<0.01). DM, particularly over the long-term, was also a risk factor for those histologically established PC patients. In summary, cigarette smoking and existing diabetes mellitus are probable risk factors for the development of pancreatic cancer in Taiwan.     

The seventh nationwide epidemiological survey for chronic pancreatitis in Japan: Clinical significance of smoking habit in Japanese patients

ObjectivesA nationwide survey was conducted to clarify the epidemiological features of patients with chronic pancreatitis (CP) in Japan.MethodsIn the first survey, both the prevalence and the incidence of CP in 2011 were estimated. In the second survey, the clinicoepidemiological features of the patients were clarified by mailed questionnaires. Patients were diagnosed by the Japanese diagnostic criteria for chronic pancreatitis 2009.ResultsThe estimated annual prevalence and incidence of CP in 2011 were 52.4/100,000 and 14.0/100,000, respectively. The sex ratio (male/female) of patients was 4.6, with a mean age of 62.3 years. Alcoholic (67.5%) was the most common and idiopathic (20.0%) was the second most common cause of CP. Comorbidity with diabetes mellitus (DM) and pancreatic calcifications (PC) occurred more frequent in ever smokers independently of their drinking status. Among patients without drinking habit, the incidences of DM and PC were significantly higher in ever smokers than in never smokers. The multiple logistic regression analysis revealed smoking was an independent factor of DM and PC in CP patients: DM, Odds ratio (OR) 1.644, 95% confidence interval (CI) 1.202 to 2.247 (P = 0.002): PC, OR 2.010, 95% CI 1.458 to 2.773 (P < 0.001). On the other hand, smoking was not identified as an independent factor for the appearance of abdominal pain by this analysis.ConclusionThe prevalence of Japanese patients with CP has been increasing. Smoking was identified as an independent factor related to DM and PC in Japanese CP patients.     

Clinical epidemiological analysis of the relationship between pancreatic cancer and diabetes mellitus: Data from a single institution in China

OBJECTIVE: To investigate the relationship between pancreatic cancer (PC) and diabetes mellitus. METHODS: All PC patients diagnosed and treated at Zhongshan hospital from January 1991 to December 2007 were retrospectively analyzed. During this period, 770 non‐digestive tract, non‐neoplastic and non‐hormone‐related patients matched for sex and age were collected as controls. The incidence of diabetes mellitus between the two groups was compared. RESULTS: Between the PC group and the control group, sex and age of the patients were well matched. The incidence of diabetes mellitus was 34.63% in the PC group and 8.83% in the control group (P < 0.001, RR = 5.19). In the PC group there was no correlation between age, sex, site of the cancer, tumor differentiation, lymph node metastasis, TNM staging and the incidence of diabetes mellitus. In this group with diabetes, 74.56% experienced onset within two years of cancer diagnosis. Of the control patients, 57.35% had had diabetes for under 2 years (P = 0.009, RR = 2.18). In the PC group with diabetes, 5.9% had had diabetes for more than 10 years while compared with 8.8% of the controls (P = 0.42). CONCLUSION: Whether diabetes mellitus is a result of or a risk factor for PC is still unclear. The incidence of diabetes mellitus is much higher in the PC patients. The onset of diabetes mellitus in adults might be an alerting factor that could lead to an early diagnosis of pancreatic cancer.     

The impact of diabetes mellitus at the time of heart transplantation on long-term survival

AIMS/HYPOTHESIS: To analyse the impact of diabetes mellitus (DM) at the time of heart transplantation on long-term survival and incidence of transplant coronary artery disease (TxCAD). METHODS: We analysed 773 consecutive adult heart transplant recipients who underwent primary heart transplantation from May 1986 until December 2000. The cohort consisted of 140 patients with diabetes mellitus (with DM, men 82%) and 633 patients without (wo DM, men 84%) diabetes mellitus at the time of transplantation. The patients were documented as to survival and incidence of TxCAD. RESULTS: Patients with diabetes mellitus were older compared to those without diabetes mellitus (with DM 54.9+/-6.8a vs wo DM 49.7+/-10.8a; p=0.0001), they had a higher incidence of ischaemic cardiomyopathy prior to transplantation (with DM 52% vs wo DM 30%; p=0.0001), but reduced long-term survival (10 year survival: with DM 40% vs wo DM 58%; log-rank=0.025). Surprisingly, the incidence of transplant coronary artery disease (TxCAD) was comparable at 10 years (with DM 28% vs wo DM 22%; log-rank=0.625). In multivariate Cox proportional hazard analysis, diabetes mellitus present at the time of heart transplantation (HR 1.594; 95%CI 1.009-2.518; p=0.045), but not age (HR 0.990; 95%CI 0.965-1.014; p=0.404) was an independent predictor affecting long-term survival. CONCLUSION/INTERPRETATION: The presence of diabetes mellitus at the time of heart transplantation adversely affects long-term patient survival, but does not predict the occurrence of transplant coronary artery disease. The definite mechanisms of adverse survival primarily seem to relate to generally impaired global organ function. Despite a less favourable long-term outcome, our data still justify heart transplantation in end-stage heart failure patients with diabetes mellitus.     

Admissions for diabetic ketoacidosis in ethnic minority groups in a city hospital

Hospitalization for diabetic ketoacidosis (DKA) is increasing, perhaps due to the rising incidence of DKA in patients with type 2 diabetes mellitus (T2DM). Ethnic minority groups are at increased risk for T2DM. This study aimed at elucidating the characteristics of patients with ketosis-prone diabetes in a predominantly ethnic minority population. We performed a retrospective analysis of adults admitted with DKA at the Bronx Lebanon Hospital Center, Bronx, NY over 3 years. The patients were divided into cohorts based on type of diabetes and ethnicity. The cohorts were described and compared using statistical methods. We recorded 219 cases of DKA in 168 patients, 97% of whom were African American or Hispanic. Fifty-three (32%) patients had T2DM. New-onset diabetes, which was more common in T2DM (P < .0001), and African Americans (P = .008), occurred in 42 patients (25%). Readmission with DKA was more common in the Hispanic patients with type 1 diabetes mellitus (T1DM) (P = .0001). Type 2 diabetes mellitus was more prevalent in the African Americans (P = .04). Patients with T1DM had more severe acidosis than patients with T2DM (lower pH and bicarbonate and larger anion gap; P = .03, .02, and .005, respectively). Creatinine level was higher in patients with T2DM (P = .04) who were also less likely to have identifiable precipitating causes (P = .02). Hemoglobin A(1c) level was higher in patients with new-onset diabetes (P < .05), but did not differ between those with T1DM and T2DM. Mortality, which was 2%, occurred only in the African Americans with T2DM. We conclude that DKA is an important mode of initial presentation of T2DM, with new-onset T2DM accounting for about 60% of all new cases of DKA. African American patients with T2DM, in comparison with the Hispanic patients, are more susceptible to developing DKA. Diabetic ketoacidosis could occur in T2DM without any identifiable precipitant. The rising incidence of DKA may be attributable to its increasing occurrence in T2DM; therefore, measures aimed at primary prevention of T2DM are worthwhile.     

Gastroesophageal reflux disease related to diabetes: Analysis of 241 cases with type 2 diabetes mellitus

BACKGROUND AND AIM: We examined the incidence of symptomatic gastroesophageal reflux disease (GERD) in patients with type 2 diabetes mellitus (DM). METHODS: Patients comprised those with DM or chronic hepatitis C (CHC) who visited Osaka Prefectural General Hospital in the same study period. Reflux symptoms were examined using a self-administered questionnaire. A total score of 4 or more was considered an indication of symptomatic GERD. Disease duration, hemoglobinA1c and diabetic complications were assessed. RESULTS: Patients with DM (n=241) or CHC (n=42) were recruited for the study. Of the 241 patients with DM, 100 (41.5%) reported experiencing upper gastrointestinal symptoms, whereas only 9 of 42 (21.4%) patients with CHC reported upper gastrointestinal symptoms (P=0.0137). Sixty-one patients (25.3%) with DM had reflux symptoms but only four patients (9.5%) with CHC reported reflux symptoms. The incidence of symptomatic GERD was significantly higher in patients with DM than in those with CHC (P=0.0219). Patients with DM for less than 5 years had a 2.4-fold higher incidence of GERD than patients with CHC. The incidence tended to rise with increased disease duration. Patients with diabetic complications reported reflux symptoms more frequently. The incidence decreased, however, in DM patients who had these conditions for more than 16 years. CONCLUSIONS: Type 2 diabetes mellitus is a risk factor for symptomatic GERD. In DM patients, use of oral hypoglycemic agents, body mass index, disease duration and the quality of diabetic control influenced the incidence of GERD.     

糖尿病对冠状动脉狭窄左室舒张末压的影响

目的:探讨糖尿病对冠状动脉狭窄患者左室舒张末压的影响。方法:选择行冠状动脉造影及左室造影的冠脉狭窄的患者662例,将之分为冠状动脉狭窄并发糖尿病组（CHD+DM组）110例,及单纯冠状动脉狭窄组（CHD组）552例,所有患者都进行左室造影,测定左室射血分数（LVEF）及左室舒张末压（LVEDP）。结果:两组患者LVEF间无明显差异,但CHD+DM组患者的LVEDP显著高于CHD组。结论:糖尿病可以加重冠状动脉狭窄对左室舒张功能的损害,引起LVEDP增高。     

老年胰腺癌与糖尿病关系分析

目的分析老年胰腺癌的临床特征，探讨老年胰腺癌与糖尿病之间的关系。方法对2003年1月。2006年12月华东医院老年（≥60岁）胰腺癌病例进行回顾性分析，评价胰腺癌与糖尿病的关系；对胰腺癌合并糖尿病病例分析、评价老年胰腺癌合并糖尿病患者的临床特点及意义。结果1．老年胰腺癌的临床表现以黄疸、消瘦、腹胀和上腹不适为主。2．在胰腺癌组中2年内确诊糖尿病有31例（39．24％），而对照组中有4例（5．0％），两组比较差异有统计学意义。胰腺癌组中糖尿病病史两年以上有11例（13．92％），对照组中有6例（7．5％），两组差异无统计学意义（P〉0.05）。3．老年胰腺癌合并糖尿病患者罹患胰头癌比例高，且CA199阳性率高于非糖尿病患者，两者差异有统计学意义（p〈0．05）。结论糖尿病是胰腺癌的继发性的临床伴发症状，所以老年人一旦出现血糖异常波动，须警惕胰腺癌的可能。