2型糖尿病与结直肠癌的相关性及合并2型糖尿病的结直肠癌的特点

摘要

目的 探讨2型糖尿病与结直肠癌的相关性,分析合并2型糖尿病的结直肠癌的特点.方法收集结直肠癌患者844例(结直肠癌组)和非肿瘤患者1 275例(对照组)的临床资料,应用Logistics回归模型分析2型糖尿病与结直肠癌是否存在相关性.根据是否合并2型糖尿病,将结直肠癌患者分为结直肠癌合并2型糖尿病组及结直肠癌未合并2型糖尿病组,比较2组患者的性别比、年龄分布、组织学类型Dukes期及病灶分布.结果 Logistic回归模型分析显示结直肠癌合并2型糖尿病组患者的患病风险是结直肠癌未合并2型糖尿病组的3.572倍,P=0.000.结直肠癌合并2型糖尿病组患者年龄≥60岁者153例(62.4%),40~59岁者82例(33.5%),＜40岁者10例(4.1%);结直肠癌未合并2型糖尿病组患者年龄≥60岁者322例(53.8%),40~59岁者208例(34.7%),＜40岁者69例(11.5%).结直肠癌合并2型糖尿病组患者年龄≥60岁者比例高于结直肠癌未合并2型糖尿病组,＜40岁者比例较低,2组比较差异均有统计学意义(均P＜0.05).结直肠癌合并2型糖尿病组病灶分布在直肠151例(61.6%),结肠94例(38.4%),结直肠癌未合并2型糖尿病组病灶分布在直肠323例(53.9%),结肠276例(46.1%),2组间差异有统计学意义(均P＜0.05).结直肠癌合并2型糖尿病组患者Dukes' A期17例(6.9%),B期76例(31.1%),C+D期152例(62.0%);结直肠癌未合并2型糖尿病组患者分别为64例(10.7%)、221例(36.9%)、314例(52.4%);结直肠癌合并2型糖尿病组患者处于Dukes' C+D期比例高于结直肠癌未合并2型糖尿病组患者,差异有统计学意义(P=0.011).结论 2型糖尿病是结直肠癌的危险因素,合并2型糖尿病的结直肠癌主要发生于≥60岁的患者,病变主要分布在直肠,预后较差.%Objective To discuss the correlation between type 2 diabetes mellitus and colorectal cancer; to analyze the features of colorectal cancer with type 2 diabetes. Methods Clinical data of 844 patients with colorectal cancer and 1275patients without tumor were collected; colorectal cancer patients were divided into colorectal cancer patients with type 2 diabetes mellitus group and colorectal cancer patients without type 2 diabetes mellitus. Sex, age distribution, histological type Dukes and lesion distribution in both groups were compared. Results There were 245 cases(29.0%) of colorectal cancer with type 2 diabetes and 103 cases (8.1%)of colorectal cancer without type 2 diabetes. Logistics binary regression model analysis results showed that type 2 diabetes was a risk factor for colorectal cancer (OR=3.572,P=0.000). Age ≥ 60 years in colorectal cancer patients with type 2 diabetes group were 153 cases ( 62.4% ),40 to 59 years were 82 cases ( 33.5% ) , <40 years were 10 cases ( 4.1% );Age ≥ 60 years in colorectal cancer patients without type 2 diabetes mellitus group were 322 cases (53.8%), 40 to 59 years were 208 cases (34.7%), <40 years were 69 cases (11.5%). The proportion of Age ≥ 60 years in colorectal cancer patients with type 2 diabetes group was higher than that in colorectal cancer patients without type 2 diabetes group,there were statistically significant (P<0.05).In colorectal cancer patients with type 2 diabetes group,Distribution of lesions in the rectum were 151 cases (61.6%), in colon were 94 cases (38.4%);In colorectal cancer patients without type 2 diabetes group,Distribution of lesions in the rectum were 323 cases (53.9%), in colon were 276 cases (46.1%), the difference between the two groups was statistically significant (P<0.05). There were 17cases(6.9%) of Dukes' A in colorectal cancer with type 2 diabetes, Dukes' B 76 cases(31.1%) and Dukes' C+D 152 cases(62.0%). There were 64 cases(10.7%) of in Dukes' A in colorectal cancer with type 2 diabetes, Dukes' B 221 cases(36.9%) and Dukes'C+D 314 cases(52.4%). Colorectal cancer patients with type 2 diabetes had a higher rate of in Dukes' C+D; two groups were statistically different (P=0.011). Conclusion Type 2 diabetes is a risk factor for colorectal cancer. Type 2 diabetes with colorectal cancer mainly occurred in ≥ 60 years of age; lesion mainly distributes in rectum; the prognosis of cancer is poor.