新疆女性乳腺癌合并2型糖尿病的临床分析

Clinical analysis of breast cancer patients with type 2 diabetes mellitus in Xinjiang

目的:分析新疆合并有糖尿病的可手术的女性乳腺癌患者的临床病理学特征及预后。方法:选取1998年1月～2002年10月新疆医科大学附属肿瘤医院收治的可手术的女性乳腺癌60例,按是否合并有糖尿病分为糖尿病组和非糖尿病组,比较两组的临床病理学特征及5年总生存率、无瘤生存率。结果:两组在产次、家族史、雌孕激素受体方面无明显差异。糖尿病组中维吾尔族患者占73.3%,平均年龄为(54+10.4)岁,处于绝经期患者为63.3%,均明显高于非糖尿病组(P<0.05)。虽然两组在肿瘤大小(T)上无明显差异,但淋巴结转移数目(N)、临床分期(Ⅰ～Ⅲ)上糖尿病组明显高于非糖尿病组,差异具有统计学意义(P<0.05),糖尿病组与非糖尿病组中N1、N2的比例之比分别为10%∶53.3%和73.3%∶26.7%。糖尿病组中83.3%的患者为Ⅲ期,而非糖尿病组以Ⅱ期患者多,占56.7%。两组随访5年,非糖尿病组无瘤生存率明显高于糖尿病组(P<0.05),但两组的总生存率无明显差异。结论:新疆维吾尔族女性乳腺癌患者合并糖尿病的较多见,且分期较晚,预后较差。故糖尿病是乳腺癌预后不好的因素之一。

Objective： To analyze the clinicopathologic features and prognosis of breast cancer with type 2 diabetes mellitus. Methods： A total of 60 cases of operable breast cancer patients in our hospital between January 1998 and June 2002 were analyzed. The patients were divided into two groups according to incidence of 2 diabetes mellitus （MS）. The clinicopathologie features and survival rates of the two groups were compared. Results： Two groups were well balanced for parity, family history and hormone-receptors. In diabetic breast cancer groups, 73. 5% were Uygur nationality, the mean age was （54± 10. 4） years, 63.3% patients were among post-menopausal. These incidence rates were higher than those of non-diabetic breast cancer patients （P 〈0.05）. N0 significant difference was seen in the tumor size, but amounts of lymph node metastasis and TNM stage between the study groups were higher among the diabetic patients （P〈0.05）, mainly due to difference in N1, N2 （10% ： 55.3% and 73.3% ： 26.7% respectively）. Analysis of TNM stage, 83.4% of diabetes patients were diagnosed at stage of Ⅲ , however 56.7% of no-diabetes patients were diagnosed stage of Ⅱ. The 5-year disease-free rates were significantly lower in diabetes patients than in non-diabetes patients （60% ： 86.7%）, but no differences was noticed in the percentage of 5-year overall survival rates （86.6% VS 93.3%）. Conclusion： Diabetes breast cancer was commonly seen in Uygur nationality with stage of Ⅲ and with poor prognosis. Our results show that diabetes mellitus is associated with negative prognosis factors at breast cancer presentation.