糖尿病患者罹患结直肠癌危险性分析

Risk factors analysis on patients suffering from diabetes with colorectal cancer

目的研究糖尿病与结直肠癌相关关系，为结直肠癌病因学探讨及预防筛查提供依据。方法回顾性分析2013年3月至2015年3月在山西大医院、山西医科大学第一附属医院住院的，经病理科确诊，病例详细记载有检验数据、糖尿病史、糖尿病家族史、结直肠癌家族史312例结直肠癌患者为病例组，按匹配原则选择同时期住院的非结直肠癌患者423例作为对照组。采用Logistic回归分析方法研究结直肠癌是否与糖尿病有关联。记录并分析病例组中糖尿病患者的患病病程以及结直肠癌发病部位并进行统计学处理。结果Logistic逐步回归分析方法显示糖尿病史、结直肠癌家族史是结直肠癌的独立危险因素。糖尿病病例组中〈5年、5～10年、10~20年、〉20年的OR值分别是2．869、3．130、3．228、1．267。糖尿病与结直肠癌发生的部位差异有统计学意义（P〈0．05）。结论（1）糖尿病增加了罹患结直肠癌的相对危险性，是结直肠癌发生的独立危险因素。（2）随着糖尿病病程的增加，结直肠癌的危险性增加，若病程超过20年，风险反而下降。（3）糖尿病引起结肠癌的患病风险增加，以右半结肠较为明显。

Objective To provid the basis for the etiology, prevention, and coloreetal cancer screening by studying the correlation between diabetes and colorectal cancer. Methods A retrospective analysis from March 2013 to March 2015 in Shanxi Dayi Hospital and First Affiliated Hospital of Shanxi Medical University. 312 patients were confirmed by pathology and consists of the case group. Results of testing, history of diabetes, family history of diabetes, and family history of colorectal cancer should be included in the medical records. Matching the principle of non-selection, 423 patients with colorectal cancer during the same period of hospitalization consists of the control group. Logistic regression was used to analysis the correlation between colorectal cancer and diabetes. Courses of diabetes and locations of colorectal cancer were recorded and analyzed with SPSS 19.0. Results Logistic regression analysis showed history of diabetes and family history of colorectal cancer were independent risk factors for colorectal cancer. Cases of diabetes group 〈5 years, 5 to 10 years,10 to 20 years, 〉20 years OR values were 2.869, 3.130, 3.228, 1.267. Diabetes and the locations of Colorectal cancer were statistically significant （P〈0.05）. Conclusion Diabetes was a independent risk factor for colorectal cancer by increasing its risk of incidence. The risk of colorectal cancer increases with the increasing duration of diabetes over time, but risk decreased if the duration was over 20 years. Diabetes increases the risk of colon cancer, especially in the fight hemicolon.