糖尿病与胰腺癌的关系探讨

The risk analysis of diabetes mellitus complicated by pancreatic carcinoma

目的探讨糖尿病与胰腺癌的关系。方法采用病例对照研究的方法将吉林大学中日联谊医院2000-01-01—2004-05-31期间收治的147例胰腺癌患者和同期住院的294例非肿瘤患者,按照美国糖尿病学会(ADA)1997年糖尿病诊断标准新建议分为糖尿病组和非糖尿病组,分析糖尿病对胰腺癌患病率的影响。结果合并糖尿病者患胰腺癌的OR值为27.26(P<0.05),其中男29.56,女25.29,性别间比较差异无显著性意义。糖尿病病程<2年者患胰腺癌的OR值为23.98,病程2～5年者患胰腺癌的OR值为17.04,病程>5年者患胰腺癌的OR值为33.32(P均<0.05)。肿瘤发生部位与糖尿病之间无明显相关性(P>0.05)。结论糖尿病患者中胰腺癌的发病率明显增加,2型糖尿病可能是胰腺癌的首发症状,对病程<2年的"糖尿病新患者",尤其是无糖尿病家族史者,应当注意排查胰腺癌。对病程>2年的糖尿病患者,随着糖尿病病程增加,患病危险性增加,而在不同性别糖尿病患者之间患胰腺癌的风险差异无显著性意义。

Objective To investigate whether diabetes mellitus（DM）causes the pancreatic carcinoma（PC）. Methods We conducted the hospital-based case-control study to compare 147 cases of PC patients with 294 non-cancer inpatients at the same time, who were divided into diabetes team and non-diabetes team according to the new proposals for diabetes mellitus diagnosis standards made by American Diabetes Association（ADA） in 1997,in order to analyse the effect of DM on the prevalence of PC. Results Among 147 PC patients, the OR of PC in the diabetes team was 27. 26. Among male patients,the OR of PC in paitents who had diabetes was 29. 56, while among female patients the OR of PC in paitents who had diabetes was 25.29 ;there was no obvious difference between sexes. The OR of having PC in patients who suffered from DM less than 2 years was 23. 98,and that of those suffering from DM for 2 to 5 years was 17.04,and that of those suffering from DM more than 5 years was 33, 32. There was no obvious correlation between the location of PC and DM （P 〉 0. 05）. Conclusion Among the DM patients, the incidence rate of PC is obviously increasing, and with the course of DM elongating,the risk of PC is increasing. There is no obvious difference between sexes. Compared with common people,the incidence rate of PC in DM patients is higher. Type 2 diabetes mellitus might be initial symptom of PC.