糖尿病与结直肠癌临床病理因素及预后的相关性研究

Impact of diabetes mellitus on clinicopathological factors and prognosis of patients with colorectal cancer

目的探讨糖尿病对结直肠癌临床病理因素及预后的影响。方法采用回顾性研究的方法，将2000年1月至2007年6月收治的共计599例结直肠癌患者分为糖尿病组（DM组）和非糖尿病组（NDM组），比较两组性别、年龄等一般情况及临床病理因素的差异并作Logistic多因素回归分析；并对直接接受根治手术的402例患者进行预后影响因素的Cox回归分析。结果本组患者中共58例（9．7％）罹患糖尿病，糖尿病组与非糖尿病组患者在体质量、年龄、是否合并高血压方面差异均有统计学意义（P〈0．05）；两组在肿瘤组织学分级、浸润、淋巴转移、TNM分期及脉管癌栓方面差异均无统计学意义（P〉0．05）。Logistic多因素回归分析显示糖尿病与结直肠癌的病理因素无相关性（P〉0．05）。直接接受根治手术的患者生存分析显示：术后3年的转移复发Kaplan-meier曲线及生存曲线有、无糖尿病的两组间差异均无统计学意义（P=0．521、0．909）；多因素Cox回归分析未提示糖尿病与结直肠癌患者预后相关（P=0．991）。结论在接受了外科手术的结直肠癌患者中，糖尿病与结直肠癌的临床病理因素无相关性；罹患糖尿病并不改变结直肠癌患者的预后，糖尿病在结直肠癌发展与转归的作用尚需进一步研究。

Objective To analyze the impact of diabetes mellitus on the clinicopathological factors and prognosis of patients with colorectal cancer. Methods A total of 599 patients with colorectal cancer treated between January 2000 and June 2007 were collected retrospectively. The patients were divided into diabetes mellitus （DM） group and non-diabetes mellitus （NDM） group. The pathologic factors data was compared between the two groups, and the Logistic multivariable analysis was performed. The Cox regression model analysis of prognosis data was applied in 402 patients who underwent radical surgery without preoperative neoadjuvant therapy. Results A total of 58 cases （ 9.7% ） developed diabetes mellitus. Significant differences was found in the body-weight, age, hypertension between the two groups （P 〈 0. 05 ）,while no significant differences in the pathologic factors, such as tumor differentiation, invasion depth, lymph node involvement, TNM stage and lymphovascular invasion was found between the two groups （P 〉 0. 05）. There was no significant correlation between diabetes mellitus and the pathologic factors on the Logistic analysis （ P 〉 0.05 ） . Among the patients underwent radical surgery directly, neither disease progression curve （ P = 0. 521 ） nor overall survival curve （ P = 0. 909 ） presented significant differences between the two groups. It＇s not shown that diabetes mellitus was significantly associated with the prognosis of patients with colorectal cancer by using Cox regression analysis （ P = 0. 991 ）. Conclusions Diabetes mellitus does not significantly influence the clinicopathological factors and the prognosis of colorectal cancerin patients receiving radical surgery, and it requires more investigation.