糖尿病与结直肠癌患病危险关系的调查分析

Investigation on the risks of colorectal cancer in patients with diabetes mellitus

目的:了解糖尿病(DM)与结直肠癌患病的关系,明确糖尿病相关因素对结直肠癌发病的影响.方法:采用病例对照的方法分析同时期住院的结直肠癌(n=364)与非肿瘤患者(n=733)与糖尿病相关因素的关系及差异.对比分析两组患者的糖尿病患病情况、糖尿病家族史、结直肠癌家族史、并发病情况、吸烟、饮酒等生活行为以及血脂水平等方面的差异.结果:结直肠癌组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,有糖尿病家族史者患结直肠癌的危险度也明显增加(OR=1.64);有结直肠癌家族史的糖尿病患者患结直肠癌的风险度(OR=3.23)高于无结直肠癌家族史的糖尿病患者(OR=1.57);但通过进一步分层分析表明无论患者有无结直肠癌家族史,结直肠癌组糖尿病患者所占比例均高于对照组.多因素回归分析显示:年龄、性别、糖尿病家族史、冠心病、高血压、吸烟、饮酒及血脂对结直肠癌没有显著影响;糖尿病及结直肠癌家族史对结直肠癌患病具有显著影响(OR=2.99,P<0.01;OR=1.79,P<0.01).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,其是结直肠癌患病的独立危险因素.

AIM： To investigate the influences of DM- associated factors on the pathogenesis of colorectal cancer （CRC）, and clarify whether diabetes mellitus （DM） is a risk factor of CRC. METHODS： A case-control study was performed to compare 364 colorectal cancer patients （198 colon cancer patients and 166 rectal cancer patients） with 733 controls （patients without cancer）, with respect to their family history of CRC and DM, personal DM history, habits of smoking and drinking, cholesterol and triglyceride levels. RESULTS： The value of odds ratio （OR） in patients with DM history was 1.72 and that in patients with family DM history was 1.64. The value of OR in DM patients with family CRC history was 3.23, significantly higher in DM patients without family CRC history （OR = 1.57）. After further analysis, the rate of DM patients with/without family CRC history was always higher than that in the controls. Logistic analysis showed that the age, gender, DM history, coronary heart disease, hypertension, smoking, drinking, and blood lipid had no marked relationship with colorectal cancer, but DM and family CRC history were correlated with the occurrence of colorectal cancer （OR = 2.99, P 〈 0.01; OR = 1.79, P 〈 0.01）. CONCLUSION： DM is an independent risk factor of CRC. Routine examination for CRC is recommended for DM patients to make earlier diagnosis of CRC and improve the prognosis of patients.