糖尿病与胰腺癌关系的临床分析

Clinical analysis of relationship between diabetes mellitus and pancreatic carcinoma

目的 分析 47例胰腺癌合并糖尿病的临床和病理学特征 ,初步探讨糖尿病与胰腺癌之间的关系。方法 对胰腺癌合并糖尿病及同期收治的未合并糖尿病的胰腺癌患者进行回顾性对比分析。结果 (1)胰腺癌合并糖尿病的患者 ,占本研究中胰腺癌的 2 5 % ;(2 )两组患者均主要发生于中老年人 ,以男性多见 ,主要临床表现为上腹痛、黄疸 ;(3)两组患者胰腺癌大小、部位、胰外浸润或远处转移以及肿瘤切除率无显著性差异 ;(4 )病理学检查糖尿病组以乳头状或高分化腺癌多见 ,非糖尿病组以中、低分化腺癌多见 ;(5 )糖尿病先于胰腺癌诊断者占 19.2 % ,与胰腺癌同时诊断者占 80 .8%。结论 (1)糖尿病可能是胰腺癌的危险因素之一 ;(2 )对中老年糖尿病患者宜常规行胰腺B超检查 ,定期随访 ,以期早期诊断 ,及时治疗 。

Objective To analyse the clinical and the pathological characteristics of pancreatic carcinoma in diabetics (DPC) and to explore the relationship between diabetes mellitus and pancreatic carcinoma (PC). Methods Medical records of 47 DPC and 140 non diabetic pancreatic carcinoma (NDPC) in the same period were carefully and retrospectively reviewed, and comparison of clinical features between two groups was made. Results (1)The patients with DPC account for 25% of pancreatic carcinoma in this study; (2)Patients of both groups often occurred in elders with a male preponderance over female; upper abdominal pain and jaundice were the major clinical manifestations; (3)There was no significant difference between these two groups in tumor size, location, extrapancreatic invasion or distant metastases as well as tumor resectablity; (4)Pathological examination revealed that papillary or well differentiated adenocarcinoma was seen in 55% of the DPC patients, while moderately and poorly differentiated adenocarcinoma was present in 80.4% in NDPC patients (P<0.001); (5)The diagnosis of diabetes preceded the diagnosis of pancreatic cancer was 19.2%, and diabetes and pancreatic cancer diagnosed at the same time was 80.8% in DPC group. Conclusion (1)Diabetes may be a risk factor for pancreatic cancer; (2)For elder diabetics, a careful examination of the pancreas is important in order to rule out early pancreatic carcinoma and to improve the prognosis of patients.