合并2型糖尿病的乳腺癌患者的预后评价

Clinical evaluation of prognosis of breast cancer patients with type 2 diabetes mellitus

目的:分析云南省合并有2型糖尿病的Ⅰ～Ⅳ期的女性乳腺癌患者的临床病理学特征及5年生存率、5年无瘤生存率,并对预后作出评价。方法:选取2001年1月～2005年1月收治的Ⅰ～Ⅳ期的女性乳腺癌患者60例,按是否合并有2型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、5年生存率及5年无瘤生存率。结果:糖尿病组和非糖尿病组在肿瘤原发灶大小(T)、雌、孕激素受体、Her-2/neu表达方面无明显差异;但淋巴结转移数目(N)上糖尿病组明显高于非糖尿病组,差异有统计学意义(P=0.035)。两组随访5年,非糖尿病组无瘤生存率高于糖尿病组(P=0.020),但两组的总生存率无明显差异(P=0.671)。结论:合并2型糖尿病的乳腺癌患者分期较晚,预后较差。故糖尿病是影响乳腺癌患者预后的因素之一。

Objective： To analyze the clinic pathological features, 5-year overall survival rates and 5-year disease-free rates of patients associated with stage I -IV of breast cancer combined type 2 diabetes mellitus in women and evaluated the prognosis of them. Methods： A total of 60 cases of breast cancer patients in our hospital between January 2001 and January 2005 were analyzed. The patients were divided into two groups according to incidence of type 2 diabetes mellitus （MS）.The factors of the clinic pathologic features and 5-year survival rates and 5-year disease-free rates of the two groups were compared. Results： There was no obvious difference between the diabetic group and non-diabetic group in the prima- ry tumor size （T）, estrogen and progesterone receptor, Her-2/neu expression. However, there was difference in the number of lymph node metastasis （N） on the diabetic group than non-diabetic group, the difference was significant （P=0.035）. The two groups were followed up for 5 years, the 5-year disease-free rates were significantly lower in diabetes patients than that in non diabetes patients （P--0.020）, but no difference was noticed in the percentage of 5-year overall survival rates （P=0.671）. Conclusion： The stage of breast cancer is late in the patients associated with type 2 diabetes mellitus, and the prognosis is bad. Our results show that diabetes mellitus is one of the prognosis factors for breast cancer.