2型糖尿病对原发性肝癌发病的危险性分析

The risk analysis of type 2 diabetes mellitus to the development of primary liver carcinoma

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。

Objective To investigate whether diabetes mellitus（DM） could cause primary liver carcinoma （PLC）. Methods We conducted the hospital-based case-controled study to analyse the effect of DM on the development of PLC.Results Among the male patients of 848 PLC cases, the OR of PLC in paitents who have diabetes was 11.78, while among female patients the OR was 8.21. There was no obvious difference between sexes. The OR in PLC patients who suffered DM less than 5 years was 3.42, and those suffered DM for 5 to 10 years was 13.83, that of those suffered DM more than 10 years was 17.80. The OR of PLC patients who suffered DM but weren＇t infected with HBV/HCV and not addicted to alcohol is 2.61, the OR of PLC patients who suffered DM and were infected with HBV/HCV but weren＇ t addicted to alcohol was 11.84. Patients who suffered DM and addicted to alcohol but weren＇ t infected with HBV/HCV the OR was 5.51, The OR of PLC patients who suffered DM, infected with HBV/HCV and addicted to alcohol was 14.91, the OR of patients who were suffered DM and liver cirrhosis was 2.38. Conclusion Among DM patients, the incidence rate of PLC is obviously increase. DM is a independent risk factor and exerts synergistic effects with other risk factors such as HBV/HCV, alcoholic consumption and liver cirrhosis on the development of PLC.