糖尿病与胰腺癌发生发展的关系

Diabetes and the Development of Pancreatic Cancer

糖尿病尤其是病程5年以上的糖尿病是胰腺癌发生的一个重要危险因素,胰岛素抵抗及其介导的高胰岛素血症通过激活胰岛素/胰岛素样生长因子受体信号通路,促进细胞恶性增殖、侵袭及转移,诱使胰腺癌的发生发展。而胰腺癌合并糖尿病的患者,其糖尿病多数是在胰腺癌确诊前的3年内被发现或与胰腺癌同时诊断,很可能是胰腺癌的一个早期表现。因此针对新发糖尿病(病程在3年以内)或长期罹患糖尿病的患者应提高警惕,必要时进行相关辅助检查,有助于胰腺癌的及早诊断。

Pancreatic cancer（PC） is a highly malignant gastrointestinal cancer with rapid progression and poor prognosis.Due to the insidious onset and the absence of specific symptoms,pancreatic cancer is usually diagnosed at an advanced incurable stage.More and more studies have found that long-standing diabetes mellitus especially of 5 years or more will increase pancreatic cancer risk.Insulin resistance and induced compensatory hyperinsulinemia are widely considered to stimulate the insulin/insulin-like growth factor-1 receptor signaling pathway,then to promote cell proliferation,invasion and metastasis,which will contribute to the development of pancreatic cancer.On the other hand,diabetes may be an early menifastation of pancreatic cancer,because the duration of diabetes prior to the onset of pancreatic cancer is usually less than 3 years.Therefore,more attention should be paid to the patients,who have suffered from a long-term diabetes or new-onset diabetes less than 3 years.If necessary,relevant affliated examinations will help to diagnose PC earlier.