2型糖尿病合并妇科恶性肿瘤48例临床分析

Clinical analysis of type 2 diabetes mellitus(T2DM) with gynecology malignant tumor in 48 cases

目的：分析2型糖尿病（T2DM）合并妇科恶性肿瘤的临床特点、治疗和生存率。方法：对2001年1月-2006年12月我院收治T2DM合并妇科恶性肿瘤患者共48例的临床资料进行回顾性分析。结果：子宫内膜癌、卵巢癌和宫颈癌在T2DM妇女的发病率分别为0．96％、0．80％和0．46％；两病同时被诊断者占64．6％，宫颈癌和子宫内膜癌诊断时大部分为早期肿瘤，52．9％的卵巢癌为晚期肿瘤；全部患者平均BMI为25．74，体重超重者占79．2％、肥胖者占20．8％；患高血压病者占60．4％；三种恶性肿瘤病理类型分布与普通人群相似；所有患者都使用胰岛素控制血糖，血糖控制良好后进行恶性肿瘤治疗；随访4—76月，T2DM合并子宫内膜癌、卵巢癌和宫颈癌的3年生存率分别为65％、52％和64％，5年生存率分别为51％、42％和64％。结论：T2DM女性患者的妇科恶性肿瘤发病率较普通人群高，可能与超重和肥胖有关；其临床特点与普通人群有所不同但病理类型分布无特殊；采取积极的个体化治疗，其预后可达到普通人群的水平。

Objective： To analyze the clinical characteristics, treatment and the survival rates of women with T2DM and gynecology malignant tumor. Methods： 48 T2DM patients with gynecology malignant tumor were recruited from January 2001 to December 2006 in our hospital, and the clinical data of them were retrospectively analyzed. Results： The incidence rates of endometrial cancer, ovarian cancer and cervical cancer the in women with T2DM were 0. 96%, 0. 80% and 0.46% respectively; Cancer and T2DM were diagnosed simultaneously in 64. 6% patients in our study, and most of the patients were in early stage in cervical cancer and endometrial cancer, 52. 9% of the pa- tients with ovarian cancer were in the later stage. The average BMI of all patients was 25.74, 79. 2% of the patients were overweight and 20.8% of them were obese. The patients with hypertension occupied 60. 4% and the distribution of the three kinds of malignant tumor pathology type was similar with ordinary crowd. Insulin was used to control the blood glucose in all the patients, and the managements aimed directly at malignant tumor were undertaken followed when the blood glucose was under controlled. Follow - up were performed for 4 to 76 months, the 3 - years overall survival rates of the three kinds of malignant tumor were 65%, 52% and 64%, respectively, and the 5 - years overall survival rates were 51%, 42% and 64%, respectively. Conclusion： The incidence rates of gynecology malignant tumor in women with T2DM were higher than ordinary crowd, overweight and obesity might be one of the potential causes. The clinical characteristics are special, but the distributions of pathology type are similar with ordinary crowd. If take positive individual treatment, the prognosis could reach the ordinary level.