胰腺癌合并糖尿病的临床特征及相关性分析

Clinical Features and Correlation between Pancreatic Cancer and Diabetes Mellitus

目的:探究胰腺癌患者中糖尿病的发病率,比较胰腺癌伴糖尿病及不伴糖尿病、合并不同病程糖尿病患者的临床特征差异。方法:回顾性收集青岛大学附属医院2015年1月至2021年1月经病理确诊为胰腺癌的患者259例,记录患者的临床病理资料,运用统计学方法比较不同分组患者的临床特征差异。结果:259例胰腺癌患者中胰腺癌伴糖尿病125例(48.3%),其中新发糖尿病患者88例(70.4%),长病程糖尿病患者37例(29.6%)胰腺癌伴糖尿病组女性患者所占比例较高,吸烟患者相对较少,空腹血糖水平、CEA、CA19-9水平高于无糖尿病组,差异有统计学意义(P < 0.05)。新发糖尿病组相比于长病程糖尿病组患者年龄偏小,吸烟比例较高,差异有统计学意义(P < 0.05)。新发糖尿病组主要为I期患者(40.9%),而长病程糖尿病组II期患者所占比例最高(40.5%)。结论:胰腺癌患者中糖尿病发病率明显增加,且主要为新发糖尿病患者。新发糖尿病可能是早期无症状胰腺癌的一个重要临床表现,有助于实现胰腺癌的早期筛检。

Objective: To investigate the incidence of diabetes mellitus in pancreatic cancer and compare the differences in clinical characteristics between patients with pancreatic cancer with and without diabetes mellitus and those with different duration of diabetes mellitus. Methods: A total of 259 patients who were pathologically diagnosed with pancreatic cancer at the Affiliated Hospital of Qingdao University between January 2015 and January 2021 were retrospectively collected, the clinicopathological data of the patients were recorded, and statistical methods were used to com-pare the differences in clinical characteristics between patients in different subgroups. Results: Of the 259 patients with pancreatic cancer, 125 (48.3%) had pancreatic cancer associated with dia-betes, 88 (70.4%) had new onset diabetes, 37 (29.6%) had long duration diabetes, a higher pro-portion of female patients had pancreatic cancer associated with diabetes, relatively few patients smoked, and higher levels of fasting plasma glucose, CEA, and CA19-9 than those without diabetes (P < 0.05). Patients in the new onset diabetes group were younger and had a higher proportion smoked than those in the long duration diabetes group (P < 0.05). The new onset diabetes group was mainly stage I patients (40.9%), while the long duration diabetes group had the highest per-centage of stage II patients (40.5%). Conclusions: The incidence of diabetes is significantly in-creased among patients with pancreatic cancer and is predominantly among patients with new onset diabetes. New onset diabetes may be an important clinical manifestation of early asympto-matic pancreatic cancer and help achieve early screening for pancreatic cancer.