乳腺癌合并2型糖尿病患者的临床病理特征及预后影响因素分析

目的探讨乳腺癌合并2型糖尿病（T2DM）患者的临床病理特征及预后影响因素，为此类患者的个体化治疗提供依据。方法对解放军白求恩国际和平医院2005年1月-2007年12月收治的136例乳腺癌按是否合并T2DM分为合并T2DM组（n=49）及非合并T2DM组（n=87），对两组的临床病理资料及无病生存情况进行统计学分析。结果两组雌激素受体状况及淋巴结转移差异有统计学意义（P〈0．05）；合并T2DM组复发转移率（29％）高于非合并T2DM组（14％），无病生存率低于非合并T2DM组（P〈0．05）；Cox比例风险模型的预后分析显示，合并T2DM、淋巴结转移及雌激素受体状态是乳腺癌患者预后的独立危险因素（P〈0．01，P〈0．05）。结论2型糖尿病是乳腺癌患者复发和转移的独立危险因素，合并T2DM的乳腺癌患者需要更合理的治疗方式。

Clinicopathologic Features and Influence Factors of Prognosis in Breast Cancer Patients Complicated with Type- 2 Diabetes Mellitus

Objective To explore clinicopathologic features and influence factors in breast cancer patients com- plicated with type 2 diabetes mellitus （T2DM） in order to provide guidance for individualized treatment. Methods A total of 136 patients with breast cancer during January 2005 and December 2007 in Bethune International Peace Hospital of PLA were divided into T2DM combination group （group A, n = 49） and non-T2DM combination group （group B, n = 87） according to whether the patients were complicated with T2DM or not, and clinicopathologic data and disease-free survival condition were statistically analyzed. Results The differences in estrogen receptor （ER） and lymph nodes me- tastasis in the two groups were statistically significant （P 〈 0. 05 ） ; the recurrent metastasis rate was 29% in group A and was significantly higher than 14% in group B, and disease free survival was significantly lower than that in group B （ P 〈 0.05） ; independent risk factors in prognosis for patients with breast cancer were complication of T2DM, lymph nodes metastasis and ER expression by analyzing with Cox proportional hazards model （ P 〈 0.01, P 〈 0.05 ）. Conclusion T2DM is an independent factor for patients with breast cancer, therefore breast cancer patients complicated with T2DM need more appropriate treatment.