胰腺癌患者的糖尿病患病率及影像表现

Prevalence of diabetes mellitus in patients with pancreatic cancer:study with pancreas imaging

目的:探讨胰腺癌患者的糖尿病患病率及其影像表现。方法:搜集本院2008年1月-2015年1月经手术病理证实的52例胰腺癌患者,所有患者均具备术前CT/MRI影像资料及糖尿病检查结果。糖尿病的诊断根据2015年美国糖尿病学会诊断标准(空腹血糖浓度≥7mmol/L或随机血糖浓度≥11.1mmol/L)。根据有无糖尿病及其发生时间对所有患者进行分组,观察胰腺影像检查所示病灶部位、最大径,比较各组间病灶部位、最大径及患者年龄的差异。计量资料采用单因素方差分析(one way ANOVA),P<0.05认为差异具有统计学意义。结果:52例胰腺癌患者中,入院前即有明确糖尿病史者17例(病程5d^15年),其中新近糖尿病者(病程≤2年)6例;入院后发现糖尿病者2例;无糖尿病者33例。本组胰腺癌患者的糖尿病患病率为36.5%(19/52),新近糖尿病的患病率为15.4%(8/52)。将病程≤2年的糖尿病患者列为A组(n=8),长期糖尿病史患者列为B组(n=11),无糖尿病史者列为C组(n=33)。A、B、C三组患者性别、年龄差异均无统计学意义(χ2=0.417,P=0.922;F=0.761,P=0.473);病变最大径、发生部位差异亦无统计学意义(F=0.237,P=0.790;χ2=4.502,P=0.103)。伴随新近糖尿病的胰腺癌更好发于胰头部(75%),且患者年龄多居于61~80岁(7/52,占13.5%)。结论:胰腺癌人群中糖尿病的患病率明显超过一般人群,提示新近发现的糖尿病患者,必要时应结合临床进行胰腺癌筛查。

Objective：To investigate the prevalence of diabetes mellitus（DM）in patients with pancreatic carcinoma,and analyze their imaging findings.Methods：From January 2008 to January 2015,imaging data of 52 consecutive patients were retrospectively collected who were diagnosed as having pancreatic cancer by pathology.The clinical data and images were analyzed.The diagnosis of DM was made by blood test,according to 2015 American Diabetes Association（ADA）diagnostic criteria（fasting plasma glucose≥7.0mmol/L or a random plasma glucose≥11.1mmol/L）.The patients were divided into 3groups：Group A,new-onset DM;Group B,long-term DM;Group C,non-DM.The abdomen images were studied,and the lesion characteristics were compared among patients in different groups.One way ANOVA test was used for continuous variables.P〈0.05 was considered statistically significant.Results：Prevalence of DM in the sample of pancreatic cancer was approximately 36.5%（19/52）,while 15.4%（8/52）were new-onset DM.Among 52 patients with pancreatic cancer,17 patients had a history of DM,two patients were diagnosed as DM after hospitalization and 33 patients had no definite DM before diagnosis of cancer.Eight patients were considered to be new-onset DM with duration less than 2years.There were no significant differences in age and cancer maximum diameter among Group A,B and C（F=0.761、P=0.473,F=0.237、P=0.790）.It was obvious that cancer more likely occurred in the head of pancreas for patients with new-onset DM（75%）.Besides,patients with new-onset DM was more common in age ranging from 61 to 80years old（13.5%）.Conclusion：New-onset DM should be considered as a potential clue for screening of pancreatic cancer,and the head of pancreas should be paid more attention.