167例老年胰腺癌特点及与糖尿病、慢性胰腺炎的关系分析

The Clinical Analysis of 167 Cases with Pancreatic Carcinoma and the Relation with Diabetes Mellitus and Chronic Pancreatitis in Aged Patients

目的 :分析 16 7例老年胰腺癌的临床特征 ,探讨胰腺癌与糖尿病、慢性胰腺炎之间的关系。方法 :对 16 7例胰腺癌和16 7例对照组进行回顾性对比分析 ,计算其相对危险度 (RR) ,评价胰腺癌与糖尿病、慢性胰腺炎的关系。结果 :(1)胰腺癌的临床表现以腹痛、黄疸、消瘦、腹胀和上腹不适为主 ,男性多见。无一例是早期胰腺癌。 (2 )在胰腺癌组中 2年内确诊糖尿病有4 5例 (2 6 .95 % ) ,对照组中有 4例 (2 .4 0 % ) ,两组有显著差异 (P <0 .0 1)。胰腺癌组中糖尿病病史两年以上有 12例 (7.19% ) ,对照组中有 14例 (8.38% ) ,两组无显著差异 (P >0 .0 5 )。 (3)胰腺癌组和对照组分别检出慢性胰腺炎 6例和 1例 ,两组无显著差异 (P >0 .0 5 )。结论 :老年人胰腺癌确诊相对较晚 ,常伴有糖尿病的发生 ,但糖尿病不是胰腺癌的危险因素 ,糖尿病是胰腺癌的继发性结果。慢性胰腺炎与胰腺癌发生无相关性。老年人出现血糖异常须警惕胰腺癌的发生。

Objective: To analyse the clinical characteristics of pancreatic carcinoma(PC) and explore the relation between diabetes mellitus(DM) and pancreatic carcinoma and chronic pancreatitis(CP). Methods: 167 cases of PC and controls in old patients were retrospectively reviewed. Results: (1) PC often occurred in man; abdominal pain ?jaundice and thin are the major clinical manifestations; no patient was diagnosed at early stage. (2) The inwdent of diabetes within 2yr in PC group was 45 cases(26.95%)and the control group was 4 cases (2.40%)(P<0.01),but clinical onset of diabetes beyond 2yr in PC group was 12 cases(7.19%)and the control group was 14 cases(8.38%)(P>0.05).(3) The diagnosis of chronic pancreatitis were 6 and 1 cases in PC group and control group respectively(P>0.05).Conclusion:The diagnosis of pancreatic carcinoma for old patients was later and often followed with diabetes ,diabetes isn't a risk factor for pancreatic cancer .There was no relationship between pancreatic cancer and chronic pancreatitis. For the old with abnormal blood sugar ,a careful examination of pancreas is important to rule out early pancreatic carcinoma.